For the successful achievement of evidence-based practice, clinicians, managers and purchasers need evidence on whether a particular intervention works and ways to judge the appropriateness of the outcome criteria and measures used. Guidance is needed on what outcome measure to use, especially within routine clinical care settings. Beginning with a re-clarification of the difference between a health status and an outcome measure, the paper presents an evaluative checklist for use by clinical audit and research staff to review outcome measures for (...) use in routine care settings. Central features include the user-centredness of the measure, its psychometric properties, feasibility of use and utility. The applicability of the checklist is illustrated for outcome measurement in diabetes and stroke care. A modified form of the checklist is proposed for use by the busy clinician as an aid to the critical review of research papers within the context of evidence-based practice and to aid health care practitioners' choice of which outcome measure(s) to use within routine clinical care. (shrink)

Although there is a long-standing international debate concerning the privatization and corporatization of health services, there has been relatively little systematic analysis of the ways these types of reform manifest. We examine the impact of privatization and corporatization on public hospitals, and in particular on hospitals’ autonomy and accountability, with two aims: to uncover the key themes in the literature, and to consider implementation issues. The review of 2,319 articles was conducted using content analysis and a discussion of selected key (...) issues. Several major themes appear in the privatization and corporatization literature, including their use as tools in health systems reform, and the role of governments in sponsoring the processes. We show that much of the underlying argument is ideological rather than evidence based. Those who promote versions of privatization or corporatization claim that decreased government involvement in the management of hospitals leads inter alia to benefits such as greater efficiency, better quality services, and increased choice for patients. Those who argue against say that increased privatization leads to deleterious outcomes such as decreased equity, compromised efficiency and poorer quality of care. The evidence is often weak and at times conflicting. Privatization and corporatization are difficult to implement, and at best produce mixed results, and their impact seems to depend more on the motivation of the evaluator than the standard of the results. These debates are of a type that is to a large extent only resolvable ideologically. (shrink)

Stay up-to-date on the ethical and legal issues that affect your clinical and professional decisions! Ethical and Legal Issues for Mental Health Professionals: A Comprehensive Handbook of Principles and Standards details the ethical and legal issues that involve mental health professionals. Respected authorities with diverse backgrounds, expertise, and professional experience discuss contemporary theories emphasizing professional ethics, the ramifications of professional actions and decisions, and ethical standards on teaching, training, research, and publication. This informative handbook provides invaluable up-to-date information and guidelines (...) vital for every mental health professional. This book is a thorough examination of ethical behavior which can be used as a reference source for the professional or a textbook for graduate students. The handbook itself is divided into five sections. The first section is a detailed introduction of ethics, law, and licensing. The second section presents general ethical principles like competence, integrity, and respect for individual rights and dignity. The third section examines confidentiality, privilege, consent, and protection. The fourth section focuses on general ethical standards in practice, including sexual contact, multiple relationships, and bartering. The fifth section presents the ethical principles and standards in teaching, training, and research. Appendices include the Ethical Principles of Psychologists and Code of Conduct (American Psychological Association, 2002) and the Code of Ethics of the National Association of Social Workers (National Association of Social Workers, 1999). Ethical and Legal Issues for Mental Health Professionals: A Comprehensive Handbook of Principles and Standards discusses: the history of basic approaches and issues in ethical philosophy five fundamental areas in the process of developing competence the necessary ingredients for the mental health professional's practice of integrity aspirational versus enforceable standards of ethics concern for the welfare of others as a core ethical principle the notion of social responsibility in the ethics codes of psychologists and social workers ethical principles, statutes, and case law protecting privacy and confidentiality issues involving the therapist-patient privilege the "duty to protect" doctrine and relevant legal issues the dynamics of multiple relationships and boundary violations sexualized dual relationships between psychologists and patients possible conflict of interest in bartering for services the requirements and implementation of maintaining patient records to avoid ethical and legal problems possible ethical dilemmas involving referrals and fees much, much more This Handbook is an essential resource for all mental health professionals, including psychologists, psychiatrists, social workers, counselors, therapists, and graduate students in mental health and the related fields. Ethical and Legal Issues for Mental Health Professionals: A Comprehensive Handbook of Principles and Standards is the first of three volumes under this title. The following volumes will focus on forensic settings and special populations/special treatment modalities. (shrink)

Responding to a major pandemic and planning for allocation of scarce resources under crisis standards of care requires coordination and cooperation across federal, state and local governments in tandem with the larger societal infrastructure. Maryland remains one of the few states with no state-endorsed ASR plan, despite having a plan published in 2017 that was informed by public forums across the state. In this article, we review strengths and weaknesses of Maryland’s response to COVID-19 and the role of the Maryland (...) Healthcare Ethics Committee Network in bridging gaps in the state’s response to prepare health care facilities for potential implementation of ASR plans. Identified “lessons learned” include: Deliberative Democracy Provided a Strong Foundation for Maryland’s ASR Framework; Community Consensus is Informative, Not Normative; Hearing Community Voices Has Inherent Value; Lack of Transparency & Political Leadership Gaps Generate a Fragmented Response; Pandemic Politics Requires Diplomacy & Persistence; Strong Leadership is Needed to Avoid Implementing ASR … And to Plan for ASR; An Effective Pandemic Response Requires Coordination and Information-Sharing Beyond the Acute Care Hospital; and The Ability to Correct Course is Crucial: Reconsidering No-visitor Policies. (shrink)

Trait emotional intelligence (trait EI) covers a wide range of self-perceived skills and personality dispositions such as motivation, confidence, optimism, peer relations and coping with stress. In the last few years, there has been a growing awareness that social and emotional factors play an important part in students? academic success and it has been claimed that those with high scores on a trait EI measure perform better. This research investigated whether scores on a questionnaire measure of trait EI were related (...) to school performance in a sample of British pupils. Results showed that high performing students had higher trait EI scores than low performing students and that some aspects of trait EI (motivation and low impulsivity) as well as total trait EI were significant predictors of academic achievement after controlling for prior attainment at school. Therefore, initiatives to develop the emotional and social abilities of schoolchildren might be worthwhile and more effective than concentrating solely on teaching and curriculum activities. (shrink)

Despite the salient experience of encoding threatening events, these memories are prone to distortions and often non-veridical from encoding to recall. Further, threat has been shown to preferentially disrupt the binding of event details and enhance goal-relevant information. While extensive work has characterised distinctive features of emotional memory, research has not fully explored the influence threat has on temporal memory, a process putatively supported by the binding of event details into a temporal context. Two primary competing hypotheses have been proposed; (...) that threat can impair or enhance temporal memory. We analysed two datasets to assess temporal memory for an in-person haunted house experience. In study 1, we examined the temporal structure of memory by characterising memory contiguity in free recall as a function of individual levels of heart rate as a proxy of threat. In study 2, we replicated marginal findings of threat-related increases in memory contiguity found in study 1. We extended these findings by showing threat-related increases in recency discriminations, an explicit test of temporal memory. Together, these findings demonstrate that threat enhances temporal memory regarding free recall structure and during explicit memory judgments. (shrink)

Introduzione: L'uomo alla scoperta di se stesso, di N. Fabro.--Realtà della condizione umana e valori morali; appunti per una antropologia attuale, di S. Misser.--Fede nella creazione ed evoluzionismo, di P. Smulders.--Il senso biologico della morale di San Paolo, di José-Maria Gonzalez-Ruiz.--Immagine umanistica dell'uomo, di J.P. van Praag.--L'etica della situazione, di E. Schillebeeckx.--Dossier Teilhard de Chardin: Introduzione, Teilhard de Chardin, o della fede nell'uomo, di F.V. Joannes. Destino cosmico e destino individuale dell'uomo, di A. Catemario. L'evoluzione spirituale del genere umano, (...) di P. Martini. La Persona nel fenomeno della socializzazione, di F. Russo. (shrink)

IntroductionCognition generally declines gradually over time due to progressive degeneration of the brain, leading to dementia and eventual loss of independent functions. The rate of regression varies among the six cognitive domains. Current modality of cognitive assessment using neuropsychological paper-and-pencil screening tools for cognitive impairment such as the Montreal Cognitive Assessment has limitations and is influenced by age. Virtual reality is considered as a potential alternative tool to assess cognition. A novel, fully immersive automated VR system has been developed to (...) assess the six cognitive domains. As cognition is associated with age, VR performance is postulated to vary with age using this system.AimsThis is a feasibility study to evaluate the VR performance of cognitively healthy adults aged between 35 and 74 years old, based on the performance score and completion time using the CAVIRE system.MethodsConducted in a public primary care clinic in Singapore, 25 multi-ethnic Asian adults were recruited in each of the four age groups in years: 35–44; 45–54; 55–64, and 65–74. The eligibility criteria included a MoCA score of 26 or higher to reflect normal cognition and understanding English instructions. They completed common daily activities ranging from brushing teething to shopping, across 13 VR segments. Their performances scores and completion time were automatically computed by the CAVIRE system. These VR performance indices were compared across the four age groups using one-way ANOVA, F-test of the hypothesis, followed by pair-wise comparisons in the event of a significant F-test.ResultsOne participant dropped out from Group 1. The demographic characteristics of 99 participants were similar across the 4 age groups. Overall, younger participants in Groups 1 and 2 attained higher VR performance scores and shorter completion time, compared to those in Groups 3 and 4, in all six cognitive domains.ConclusionThe CAVIRE VR performance scores and completion time significantly differ between the younger and older Asian participants with normal cognition. Enhancements to the system are needed to establish the age-group specific normal performance indices. (shrink)

This paper starts with one of Chalmers’ basic points: first-hand experience is an irreducible field of phenomena. I claim there is no ‘theoretical fix’ or ‘extra ingredient’ in nature that can possibly bridge this gap. Instead, the field of conscious phenomena requires a rigorous method and an explicit pragmatics for its exploration and analysis. My proposed approach, inspired by the style of inquiry of phenomenology, I have called neurophenomenology. It seeks articulations by mutual constraints between phenomena present in experience and (...) the correlative field of phenomena established by the cognitive sciences. It needs to expand into a widening research community in which the method is cultivated further. (shrink)

Im Jahre 1886 erregte I. Hilberg großes Aufsehen, als er in einem Artikel über die Autorschaft des Christus patiens auf die verschiedene Behandlung der dichrona bei den Jambographen der byzantinischen Epoche hinwies – die bis heute herrschende Anschauung geht dahin, dass α, ι und υ bei den byzantinischen Jambographen ausnahmslos mittelzeitig sind – und, je nach der absoluten Korrektheit in der Versifikation, sowohl was die Quantität als was die Zäsuren betraf, die Autoren in drei Gruppen meinte einreihen zu können: die (...) Classiker, die Epigonen und die Stümper. P. Maas griff diesen Standpunkt quasi unmittelbar an; er bemerkte sarkastisch, dass in diesem Fall Georgios Pisides, umstrahlt von der Glorie reinster Quantität einsam über allen anderen Dichtern in der einsamen Höhe seines „klassischen“ Himmels thronen würde, und dass die Byzantiner in Wirklichkeit von der Quantität der Vokale nichts hörten, da dieselben einfach isochron geworden waren. Dies hat nicht verhindert, dass F. Scheidweiler lange danach doch untersucht hat, ob die Poesie des Joannes Geometres noch der antiken Quantitätslehre entspricht, oder konkreter: dem Metrum des jambischen Trimeters:In diesem Beitrag möchte ich, mit den Untersuchungen von Scheidweiler als Richtschnur, der Frage nachgehen, in welchem Maβe der Dichter in seiner Μετάφϱασις των ώδων tatsächlich noch die antike Metrik respektiert. (shrink)

This article explores the notion of the unconscious (das Unbewusste) in terms of its nature and constitutive manifestations in consciousness. In contrast to the psychoanalytic formulation, the unconscious is conceptualized here distinctively as sedimentation (die Sedimentierung) within the Husserlian framework. All `experiences sediment and are “stored” in a darkened, affectless region of the psyche, which is nonetheless not in any sense separated from the sphere of consciousness. Rather, the sedimented experiences move dynamically between the unconscious and consciousness, constantly affecting and (...) manifesting in the upcoming conscious activities of the subject. Based on this conceptualization, I suggest a schematic understanding of the manifestations of the unconscious, or sedimentation, in consciousness. The conceptual division of consciousness into the sphere of understanding (Verstandessphäre), sphere of affect (Gemütssphäre) and sphere of volition (Willenssphäre) allows us to speak of the corresponding threefold manifestations of the unconscious in each of these spheres as type (Typus), mood (Stimmung) and habits (Habitus). Having their genetic “origin” in sedimented experiences, these structural moments play a constitutive role in upcoming conscious activities of the intentional subject. Furthermore, I demonstrate that each of these moments is characterized by a distinctive kind of horizonality, in light of which a deepened understanding of the genetic concept of horizon-consciousness (Horizontbewusstsein) is obtained. Despite the conceptual tripartition, I emphasize at the end the essential intertwinement of the three structural moments in such conscious performance as association. (shrink)

Understanding the nature of science has long been a desired outcome of science education, despite ongoing disagreements about the content, structure, and focus of NOS expectations. Addressing the concern that teachers likely focus only on student learning expectations appearing in standards documents, this study examines the current state of NOS in science education standards documents from nine diverse countries to determine the overt NOS learning expectations that appeared, NOS statements provided near those learning expectations, but not identified as learning outcomes, (...) and NOS statements found in ancillary text. Findings indicate that NOS ideas rarely occur as expectations for student learning and are far more commonly found in ancillary material. Moreover, consensus was not apparent in the overt learning outcomes for students. Given the well-documented poor state of NOS instruction and the consistent lack of NOS appearing in published curriculum materials, the NOS standards appearing in nearly all documents analyzed are unlikely to provide sufficient conceptual or pedagogical support for NOS to be accurately interpreted or translated into meaningful experiences for students. (shrink)

There is an emerging consensus that we are experiencing radical change in the way that science is organized and performed. Frequently described as a shift from Mode 1 to Mode 2, this view emphasizes application, transdisciplinarity, collaboration, and accountability. This article examines the ways in which U.K. public sector scientists make sense of scientific endeavor. The data reveal that the extent to which science is being constructed varied both across and between institutions. Data highlight how individual scientists weave their own (...) paths through the changing discourses of science, constructing new understandings that do not fit neatly into any binary framework for understanding. (shrink)

There is little empirical evidence showing a direct link between a capacity for statistical learning (SL) and proficiency with natural language. Moreover, discussion of the role of SL in language acquisition has seldom focused on literacy development. Our study addressed these issues by investigating the relationship between SL and reading ability in typically developing children and healthy adults. We tested SL using visually presented stimuli within a triplet learning paradigm and examined reading ability by administering the Wide Range Achievement Test (...) (WRAT-4; Wilkinson & Robertson, 2006). A total of 38 typically developing children (mean age of 9;5 years, range 6;4–12;5) and 37 healthy adults (mean age of 21 years, range 18–34) were assessed. In children, SL was significantly related to reading ability. Importantly, this relationship was independent of grade and also age. The adult data, too, revealed that SL was significantly related to reading ability. A regression analysis of the combined child and adult data revealed that SL accounted for a unique amount of variance in reading ability, after age and attention had been taken into consideration. For the first time, this study provides empirical evidence that a capacity for more effective SL is related to higher reading ability in the general population. (shrink)

What is wrong with participating in a democratic decision-making process, and then doing something other than the outcome of the decision? It is often thought that collective decision-making entails being prima facie bound to the outcome of that decision, although little analysis has been done on why that is the case. Conventional perspectives are inadequate to explain its wrongness. I offer a new and more robust analysis on the nature of voting: voting when you will accept the outcome only if (...) the decision goes your way is an act of bad faith: you are not taking part in a ‘process that decides what we will do’. This analysis sheds light on understanding the intrinsic nature of voting and what we are doing when we make decisions collectively. (shrink)

We contribute to the literature on ethics in the professions by theorizing how global mobility precipitates professional insecurity and constrained moral agency. We present our findings of a study of accountants migrating to Canada. Using postcolonial theory and relational/poststructuralist theories of identity and ethics, we contrast the experiences of marginalized and privileged migrant accountants to show how those with “diverse” social identities are not recognized by professionals in Canada and must seek recognition from Canadian colleagues, employers, and clients to reconstitute (...) their professional identities and moral agency. We discuss the implications of the exclusion and marginalization of professionals for migrants, the profession, and society more generally. (shrink)

The scope of the issues -- The moral relationship between leaders and followers -- The morality of leaders : motives and deeds -- Puzzles and perils of transformational leadership.

This study examines how authentic leadership influences team performance via the mediating mechanism of team reflexivity. Adopting a self-regulatory perspective, we propose that authentic leadership will predict the specific team regulatory process of reflexivity, which in turn will be associated with two outcomes of team performance, effectiveness and productivity. Using survey data from 53 teams in three organizations in the United Kingdom and Greece and controlling for collective trust, we found support for our stated hypotheses with the results indicating a (...) significant fully mediated relationship. As predicted the self-regulatory behaviors inherent in the process of authentic leadership served to collectively shape team behavior, manifesting in the process of team reflexivity, which, in turn, positively predicted team performance. We conclude with a discussion of how this study extends theoretical understanding of authentic leadership in relation to teamwork and delineate several practical implications for leaders and organizations. (shrink)

Many commentators have contrasted the way that sociability is theorized in the writings of Mary Astell and Damaris Masham, emphasizing the extent to which Masham is more interested in embodied, worldly existence. I argue, by contrast, that Astell's own interest in imagining a constitutively relational individual emerges once we pay attention to her use of religious texts and tropes. To explore the relevance of Astell's Christianity, I emphasize both how Astell's Christianity shapes her view of the individual's relation to society (...) and how Masham's contrasting views can be analyzed through the lens of her charge that Astell is an “enthusiast.” In late seventeenth-century England, “enthusiasm” was a term of abuse that, commentators have recently argued, could function polemically to dismiss those deemed either excessively social or antisocial. By accusing Astell of enthusiasm, I claim, Masham seeks to marginalize the relational self that Astell imagines and to promote a more instrumental view of social ties. I suggest some aspects of Astell's thought that may have struck contemporaries as “enthusiastic” and contrast her vision of the self with Masham's more hedonistic subject. I conclude that, although each woman differently configures the relation between self and society, they share a desire to imagine autonomy within a relational framework. (shrink)

Chapters in this outstanding text are grouped into sections focusing on major themes. Each features an overview, a debate chapter, and several viewpoint chapters. This format gives students the opportunity fo analyze conflicting viewpoints and encourages critical thinking. The text boasts a well-known and well-respected author group, allowing students to learn from recognized leaders in the field. (Includes a FREE MERLIN website. at:www.harcourthealth.com/merlin/Dochterman/current/).

The University of Pittsburgh Medical Center (UPMC) "Policy for the Management of Terminally Ill Patients Who May Become Organ Donors after Death" proposes to take organs from certain patients as soon as possible after expected cardiopulmonary death. This policy requires clear understanding of the descriptive state of the donor's critical cardiopulmonary and neurologic functional capacity at the time interventions to sustain or harvest organs are undertaken. It also requires strong consensus about the moral and legal status of the donor during (...) dying and confirmation of death. There has been no need for the clarity and precision that this policy relies upon, and thus the needed research and conceptual work has not previously been generated. The empiric base and societal consensus are both too frail to provide justification for this policy at this time. (shrink)

Environmental journalism has been criticized by various special interest groups and some editors for advocacy and faulted for inaccuracies. Sources, in turn, many from the science communities, have been accused of inaccessibility, and public relations representatiws from both industry and environmental organizations are regularly blamed for unethical behaviors rangingfrom hyperbole to more serious discussion or omission of factual information. This article reports a preliminary study of ethical decision making among members of the Society of Environmental Journalists, identifying ethical motivation diljerences (...) using the Ethical Motivation Scale. The implications of the reported dominant extrinsic guides are discussed in light of a proposed protocol for ethical environmental communication. (shrink)

Advances in science have led to a new vision for toxicity testing based on human cell systems that will be more predictive, have higher throughput, cost less money, and be more comparable to real‐life exposures in humans, while using many fewer animals. This vision, embraced by leading scientific and regulatory groups, is a paradigm shift from animal‐based to human‐based testing that signals a major change in focus and promotes the development of new approaches to understanding the toxicity of chemicals in (...) humans. Information gained from these new approaches will likely affect other areas of research as well, leading to less reliance on animals in the future. (shrink)