BackgroundIt has been well documented that patients can feel abused in health care and that many patients suffer from these experiences. Insight lacks into contributing factors behind such events. Silence surrounding the abuse has been suggested as a possible mechanism. The present study explores silence surrounding the abuse as a possible contributing factor. We have explored whether this silence is connected with the staff’s hierarchical position and with the staff’s own experiences as patients abused in health care.MethodsDuring January 2008, a (...) paper questionnaire was sent to all staff members at a Swedish women’s clinic. The questionnaire included questions on sociodemography and profession and multiple questions about abuse in health care. After univariate testing, a binary logistic regression model including variables concerning profession and staff’s own experiences of abuse was built.ResultsOur data show that in contrast to midwives and gynaecologists, auxiliary nurses seldom report hearing about cases of abuse in health care. Staff who themselves experienced abuse in health care as patients, so-called wounded healers, were more likely to have heard about abuse in health care during the last 12 months.ConclusionsThis study suggests that a form of silence reigns over events of abuse in health care that is not randomly distributed over staff. Professional hierarchies and staff’s own experiences of abuse as patients could be considered in the design of interventions to break the silence surrounding patients’ experiences of abuse in health care. (shrink)

Efforts to counteract abuse in health care, defined as patient-experienced abuse, have mainly focused on interventions among caregivers. This study is the first to test an online intervention focusing on how patients can counteract such abuse. The intervention aimed at increasing patients’ intention and perceived ability to act in future situations where they risk experiencing abuse.

The goal of cognitive modeling is to build faithful simulations of human cognition. One of the challenges is that multiple models can often explain the same phenomena. Another challenge is that models are often very hard to understand, explore, and reuse by others. We discuss some of the solutions that were discussed during the 2015 International Conference on Cognitive Modeling.

The goal of cognitive modeling is to build faithful simulations of human cognition. One of the challenges is that multiple models can often explain the same phenomena. Another challenge is that models are often very hard to understand, explore, and reuse by others. We discuss some of the solutions that were discussed during the 2015 International Conference on Cognitive Modeling.

Bowers et al. counter deep neural networks (DNNs) as good models of human visual perception. From our color perspective we feel their view is based on three misconceptions: A misrepresentation of the state-of-the-art of color perception; the type of model required to move the field forward; and the attribution of shortcomings to DNN research that are already being resolved.

The biblical metaphor of covenant sets the primary issue of pastoral care, namely, grounding in another vis-á-vis self-groundedness.

David and the other actors in this narrative have enormous power and freedom to act, but they are not free to act as though Yahweh were not there.

The prayers of lament in The Psalter give a form to the worst experiences of life which follows the movement innate to human suffering and yet places it in the presence of the one who alone can address decisive word to those who suffer.

YHWH, the God of Israel, is not only a character embedded in the plot of the Book of Joshua. YHWH is the chief protagonist and the engine that drives the plot. Even when there are other actors in the plot, notably Joshua, their performances in the plot are at the behest of and in response to the intention of YHWH.

Presently, there are two views of human history vying for our allegiance. The one is grounded in the Enlightenment and insists that history is a closed process whose course is determined by the dictum that “might makes right.” The other view is that of supernaturalism, which regards every event in history as a direct act of God. Challenging both of these views is the prophetic construal of history. This construal dares to identify extraordinary human events—the promise of Isaac to Abraham (...) and Sarah, the exodus, the pronouncements of Israel's great prophets, and the ministry of Jesus—as acts of God. Such extraordinary events have the power to free us to speak of God as enacting “newness” also in our time. (shrink)

Israel characteristically met the hurtful dimensions of existence head-on, of course viewing them as faith crises, times of wondering about God and his fidelity, but also as faith opportunities, times to articulate again their expectations and assumptions, times to reformulate their position vis-à-vis the world of hurt and the God of faithfulness.

If we grant even the most general claim of the text that this is a live and authorizing word that continues to have power to liberate imagination for obedience and daring, then we are bound to ask not only what the text said but what it continues to say.

BackgroundMeasurement of tinnitus-related distress and treatment responsiveness is key in understanding, conceptualizing and addressing this often-disabling symptom. Whilst several self-report measures exist, the heterogeneity of patient populations, available translations, and treatment contexts requires ongoing psychometric replication and validation efforts.ObjectiveTo investigate the convergent validity and responsiveness of the German versions of the Tinnitus Questionnaire [TQ], Tinnitus Handicap Inventory [THI], and Tinnitus Functional Index [TFI] in a large German-speaking sample of patients with chronic tinnitus who completed a psychologically anchored 7-day Intensive Multimodal (...) Treatment Programme.MethodsTwo-hundred-and-ten patients with chronic tinnitus completed all three questionnaires at baseline and post-treatment. Intraclass correlation coefficients determined the convergent validity of each questionnaire’s total and subscale scores. Treatment responsiveness was investigated by [a] comparing treatment-related change in responders vs. non-responders as classified by each questionnaire’s minimal clinically important difference-threshold, and [b] comparing agreement between the questionnaires’ responder classifications.ResultsThe total scores of all three questionnaires showed high agreement before and after therapy. All total scores changed significantly with treatment yielding small effect sizes. The TQ and TFI yielded comparable and the THI higher responder rates. The TQ | THI and TQ | TFI showed fair, and the THI | TFI moderate agreement of responder classifications. Independent of classification, responders showed significantly higher change rates than non-responders across most scores. Each questionnaire’s total change score distinguished between responders and non-responders as classified by the remaining two questionnaires.ConclusionThe total scores of all three questionnaires show high convergent validity and thus, comparability across clinical and research contexts. By contrast, subscale scores show high inconsistency. Whilst the TFI appears well suited for research purposes, the THI may be better suited to measure psychological aspects of tinnitus-related distress and their changes with accordingly focused treatment approaches. (shrink)

The European Union Commission’s whitepaper on Artificial Intelligence proposes shaping the emerging AI market so that it better reflects common European values. It is a master plan that builds upon the EU AI High-Level Expert Group guidelines. This article reviews the masterplan, from a culture cycle perspective, to reflect on its potential clashes with current societal, technical, and methodological constraints. We identify two main obstacles in the implementation of this plan: the lack of a coherent EU vision to drive future (...) decision-making processes at state and local levels and the lack of methods to support a sustainable diffusion of AI in our society. The lack of a coherent vision stems from not considering societal differences across the EU member states. We suggest that these differences may lead to a fractured market and an AI crisis in which different members of the EU will adopt nation-centric strategies to exploit AI, thus preventing the development of a frictionless market as envisaged by the EU. Moreover, the Commission aims at changing the AI development culture proposing a human-centred and safety-first perspective that is not supported by methodological advancements, thus taking the risks of unforeseen social and societal impacts of AI. We discuss potential societal, technical, and methodological gaps that should be filled to avoid the risks of developing AI systems at the expense of society. Our analysis results in the recommendation that the EU regulators and policymakers consider how to complement the EC programme with rules and compensatory mechanisms to avoid market fragmentation due to local and global ambitions. Moreover, regulators should go beyond the human-centred approach establishing a research agenda seeking answers to the technical and methodological open questions regarding the development and assessment of human-AI co-action aiming for a sustainable AI diffusion in the society. (shrink)

The parameters governing our behavior are in constant flux, and capturing these dynamics in cognitive models remains a challenge. We demonstrate how a mapping between ACT‐R's model of declarative memory and the linear ballistic accumulator enables efficient estimation of memory parameters from data. The resulting estimates provide a cognitively meaningful explanation for observed differences in behavior over time and between individuals.

The parameters governing our behavior are in constant flux. Accurately capturing these dynamics in cognitive models poses a challenge to modelers. Here, we demonstrate a mapping of ACT-R's declarative memory onto the linear ballistic accumulator (LBA), a mathematical model describing a competition between evidence accumulation processes. We show that this mapping provides a method for inferring individual ACT-R parameters without requiring the modeler to build and fit an entire ACT-R model. Existing parameter estimation methods for the LBA can be used, (...) instead of the computationally expensive parameter sweeps that are traditionally done. We conduct a parameter recovery study to confirm that the LBA can recover ACT-R parameters from simulated data. Then, as a proof of concept, we use the LBA to estimate ACT-R parameters from an empirical dataset. The resulting parameter estimates provide a cognitively meaningful explanation for observed differences in behavior over time and between individuals. In addition, we find that the mapping between ACT-R and LBA lends a more concrete interpretation to ACT-R's latency factor parameter, namely as a measure of response caution. This work contributes to a growing movement towards integrating formal modeling approaches in cognitive science. (shrink)

Rethinking Justice lifts up and restores an idea of justice found in classical writers as well as more recent thinkers. Justice deals with righting wrongs and restoring peace to individuals and communities. We have lost sight of this and must return to it in mind and practice.

The Jeremiah portrayed in the Old Testament book bearing his name has become the paradigmatic figure of the prophet as he struggles with his God and with his own vocation of announcing God's Word to his time.

ZusammenfassungIn der Medizinethik sind der Respekt vor der Patientenselbstbestimmung, das Nichtschadensgebot, das Handeln zum Wohl des Kranken und das Gerechtigkeitsgebot praxisrelevante Prinzipien. Anhand des Beispiels der Frühintervention und Akutbehandlung schizophrener Störungen wird aufgezeigt, dass es in der psychiatrischen Praxis zu einer Kollision dieser Prinzipien kommen kann. Der frühe Krankheitsbeginn und der häufig chronische Verlauf schizophrener Störungen führen zu großem Leid der Betroffenen und ihrer Angehörigen sowie zur ökonomischen Belastung der Solidargemeinschaft. Die negativen Folgen einer verzögerten Intervention stehen den Risiken der (...) Stigmatisierung sowie den möglichen Nebenwirkungen durch die psychotherapeutische oder psychopharmakologische Behandlung gegenüber. Es wird für eine an der konkreten Situation orientierte, lebensnahe und dynamische Ethik plädiert, die vom konkreten Fall aus diskutiert und verschiedene Perspektiven berücksichtigt – mit dem Ziel von einer Arztethik und Patientenethik zu einer Verantwortungspartnerschaft zu gelangen. (shrink)