At the University of Newcastle, health law and ethics is taught and assessed in each year of the five-year curriculum. However, the critical question for assessment remains: 'Does teaching ethics have a measurable effect on the clinical activity of medical students who have had such courses?' Those responsible for teaching confront this question each year they sit down to construct their assessment tools. Should they assess what the student knows? Should they assess the student's moral reasoning, that is, what decisions (...) the student makes, and, how these decisions are justified, or should they assess what the student actually does when dealing with patients in the clinical setting, and how he or she does it? From 1982 to 1991, assessment at Newcastle was primarily aimed at determining the quality of the students' ethics knowledge base. This paper describes the strengths and limitations of a purely knowledge-based method of evaluation and why in 1992, we are now attempting to redefine and assess, what we call 'clinical ethical competence' in terms of how students actually apply this knowledge base in a controlled clinical context. (shrink)

Achieving space situational awareness requires, at a minimum, the identification, characterization, and tracking of space objects. Leveraging the resultant space object data for purposes such as hostile threat assessment, object identification, and conjunction assessment presents major challenges. This is in part because in characterizing space objects we reference a variety of identifiers, components, subsystems, capabilities, vulnerabilities, origins, missions, orbital elements, patterns of life, operational processes, operational statuses, and so forth, which tend to be defined in highly heterogeneous and sometimes inconsistent (...) ways. The Space Domain Ontologies are designed to provide a consensus-based realist framework for formulating such characterizations in a way that is both consistent and computable. Space object data are aligned with classes and relations in a suite of ontologies built around the existing Space Object Ontology. They are stored in a dynamically updated Resource Description Framework triple store, which can be queried to support space situational awareness and the needs of spacecraft operators and analysts. This paper provides an overview of the Space Domain Ontologies and their development and use. It presents the motivation for and advantages of the Space Domain Ontologies, including the benefits they provide for enhancing and maintaining long-term space situational awareness. (shrink)

The ability of the medical profession to sustain life, or more appropriately, to prolong dying, in patients with terminal illness, creates a most complex and controversial situation for all involved: the patient, if mentally alert; the patient's family; and the medical care team including physicians, nurses and attendants. This situation is especially complex in large acute care hospitals where medical and nursing students, residents and house officers receive advanced medical training. A major problem, prolonging the dying of the terminally ill, (...) with its medical, legal, ethical and economic complexities now confronts American society. The problem is particularly acute in teaching hospitals, in which one finds a disproportionate number of terminally ill patients. The ability to work at these questions as a community rather than as adversaries will determine much about the ability of the health care system to respect the dignity and autonomy of those who seek aid and comfort when faced with serious illness and impending death. Better communication between the physicians, health care providers, the lawyers and ethicists must be developed in order to solve these problems. Over the next ten years society and our elected representatives will be making very demanding decisions about the use of the health dollar. One possible way to prevent increasing costs is to reach significant agreement on the proper care of the dying. Proper care for the dying is being considered, discussed, and evaluated by very thoughtful people. It is not governments which should decide who is to live or who is to die. There is the serious problem of the 'slippery slope' to euthanasia by omission if cost containment becomes the major force in formulating policy on the proper care of the dying. (shrink)

Uncertainty and affect are fundamental and interrelated aspects of the human condition. Uncertainty is often associated with negative affect, but in some circumstances it is associated with positive affect. In this paper, we review different explanations for the varying relationship between uncertainty and affect. We identify “mental simulation” as a key process that links uncertainty to affective states. We suggest that people have a propensity to simulate negative outcomes, which results in a propensity towards negative affective responses to uncertainty. We (...) also propose the existence of several important moderators of this process, including context and individual differences such as uncertainty tolerance, as well as emotion regulation strategies. Finally, we highlight important knowledge gaps and promising areas for future research, both empirical and conceptual, to further elucidate the relationship between uncertainty and affect. (shrink)

How many words is a bilingual 2-year-old supposed to know or say in each of her languages? Speech and language therapists or researchers lack the tools to answer this question, because several factors have an impact on bilingual language skills: gender, amount of exposure, mode of acquisition, socio-economic status and the distance between L1 and L2. Unfortunately, these factors are usually studied separately, making it difficult to evaluate their weight on a unique measure of vocabulary. The present study measures the (...) contribution of the following factors to the vocabulary scores of bilingual toddlers: i) gender; ii) sibling ranking; iii) relative amount of exposure to each language; iv) mode of exposure; v) SES; vi) linguistic distance; vii) language spoken between parents. Close to the child’s second birthday, parents of 278 UK-based bilinguals completed successively: a 100-word version of the Oxford-CDI, the CDI in the child’s Additional Language, a family questionnaire, and the Language Exposure Questionnaire. Thirty-six British-English-AL pairs were considered, with languages contrasted on a second-language-learning scale : for example, Dutch and French are close to British-English, while Polish or Cantonese are more distant. Data from the corpus were included in two mixed-effect models, one with the English scores in comprehension as the dependent variable, and the other with production scores. The seven factors listed above were included as predictors. The amount of English exposure was the strongest predictor of comprehension scores = 9.35, p <.005, β = 0.02, t = 3.08, p <.005), followed by the language that parents speak between themselves = 14.94, p <.001, β = 1.37, t = 3.76, p <.0005), linguistic distance = 6.92, p <.01, β = -0.74, t = -2.66, p <.01) and age = 4.86, p <.05, β = 0.55, t = 2.17, p <.05). In production, gender = 13.57, p <.0005, β = -0.91, t = -03.72, p <.0005), amount of exposure to English = 13.57, p <.0005, β = -0.91, t = -03.72, p <.0005), the language that parents speak between themselves = 11.85, p <.005, β = 1.09, t = 3.41, p <.001), and the mother’s occupation = 4.51, p <.05, β = 0.63, t = 2.13, p <.05) were the significant predictors. The more English parents use to address one another, the more English words the child says and understands. This surprising result could be simply explained by the fact that parents who speak English together are also more likely to speak English to their child. The main results of this study is that linguistic distance is a powerful predictor of toddlers’ vocabulary in English, with children learning two close languages growing their vocabulary faster than those learning distant languages. (shrink)

Some practical problems in the teaching of ethics to medical students are described. The definition of the objectives of the course remains the central aspect, and is more important than the specific content. The use of student projects, buzz groups, case histories and discussion points is described. There is a need for student assessment or examination at the end of the course. The teachers require a broad background in philosophy, clinical medicine and teaching skills. The learning of the teachers may (...) be as important as that of the students. (shrink)

The study of the interrelationship between ethnomedicinal knowledge and socio-cultural values needs to be studied mainly for the simple reason that culture is not only the ethical imperative for development, it is also the condition of its sustainability; for their exists a symbiotic relationship between habitats and cultures. The traditional communities around Binsar Wildlife Sanctuary of Uttarakhand state in India have a rich local health care tradition, which has been in practice for the past hundreds of years. The present study (...) documents the Ethnomedicinal uses of 54 medicinal and aromatic plants (MAPs) along with their botanical and vernacular names, family, habit, habitat, threat status, collection season, purpose of collection, quantity, conservation practices, market potential and part(s) used in traditional health care system. The documented species belonging to 38 families have been used to cure more than 47 different kinds of ailments. These MAPs collected from the wild in a particular season and used as per the method prescribed by traditional herbal healers (Vaidyas) that provide effective results. Perception of local people during field trips based on socio-demographic characters showed them to prefer herbal system of treatments and they understood the status of traditional health care systems in the region. The study reveals that approximately 70 % population of the study area depend on herbal systems of treatments and preferred to visit Vaidyas for curing a variety of ailments because the traditional system of medicine is one of the most important prevailing systems in the region where modern health care facilities are rare or in very poor conditions. The organic cultivation practices of selected MAPs were demonstrated to rural inhabitants through capacity building training program and participatory action research framework approaches for sustainability and enhancement of livelihood security. A series of workshops and village level meetings on traditional health care systems were organized and forming/registered a strong association of Vaidyas for making their traditional system of health care more practical and effective. The study emphasizes the potentials of the ethnomedicinal research, conservation practices, socio-cultural and religious ethics for promoting traditional plants based treatments and also the need to document the indigenous knowledge for scientific validation before its industrial application. (shrink)

Knowledge of the ethical and legal basis of medicine is as essential to clinical practice as an understanding of basic medical sciences. In the UK, the General Medical Council requires that medical graduates behave according to ethical and legal principles and must know about and comply with the GMC’s ethical guidance and standards. We suggest that these standards can only be achieved when the teaching and learning of medical ethics, law and professionalism are fundamental to, and thoroughly integrated both vertically (...) and horizontally throughout, the curricula of all medical schools as a shared obligation of all teachers. The GMC also requires that each medical school provides adequate teaching time and resources to achieve the above. We reiterate that the adequate provision and coordination of teaching and learning of ethics and law requires at least one full-time senior academic in ethics and law with relevant professional and academic expertise. In this paper we set out an updated indicative core content of learning for medical ethics and law in UK medical schools and describe its origins and the consultative process by which it was achieved. (shrink)

Ethical reasoning and decision-making may be thought of as 'professional skills', and in this sense are as relevant to efficient clinical practice as the biomedical and clinical sciences are to the diagnosis of a patient's problem. Despite this, however, undergraduate medical programmes in ethics tend to focus on the teaching of bioethical theories, concepts and/or prominent ethical issues such as IVF and euthanasia, rather than the use of such ethics knowledge (theories, principles, concepts, rules) to clinical practice. Not surprisingly, many (...) students and clinicians experience considerable difficulty in using what they know about ethics to help them make competent ethical decisions in their day-to-day clinical practice. This paper describes the development of a seminar programme for teaching senior medical students a more systematic approach to ethical reasoning and analysis and clinical decision-making. (shrink)

In this article, an ethical analysis of an educational programme on renal replacement therapy options for patients and their social network is presented. The two main spearheads of this approach are: (1) offering an educational programme on all renal replacement therapy options ahead of treatment requirement and (2) a home-based approach involving the family and friends of the patient. Arguments are offered for the ethical justification of this approach by considering the viewpoint of the various stakeholders involved. Finally, reflecting on (...) these ethical considerations, essential conditions for carrying out such a programme are outlined. The goal is to develop an ethically justified and responsible educational programme. (shrink)