Patient report of functioning is one component of the neurocognitive exam following traumatic brain injury, and standardized patient-reported outcomes measures are useful to track outcomes during rehabilitation. The Traumatic Brain Injury Quality of Life measurement system is a TBI-specific extension of the PROMIS and Neuro-QoL measurement systems that includes 20 item banks across physical, emotional, social, and cognitive domains. Previous research has evaluated the responsiveness of the TBI-QOL measures in community-dwelling individuals and found clinically important change over a 6-month assessment (...) interval in a sample of individuals who were on average 5 years post-injury. In the present study, we report on the responsiveness of the TBI-QOL Cognition–General Concerns and Executive Function item bank scores and the Cognitive Health Composite scores in a recently injured sample over a 1-year study period. Data from 128 participants with complicated mild, moderate, or severe TBI within the previous 6 months were evaluated. The majority of the sample was male, white, and non-Hispanic. The participants were 18–92 years of age and were first evaluated from 0 to 5 months post-injury. Eighty participants completed the 1-year follow-up assessment. Results show acceptable standard response mean values for all measures and minimal detectable change values ranging from 8.2 to 8.8 T-score points for Cognition–General Concerns and Executive Functioning measures. Anchor rating analysis revealed that changes in scores on the Executive Function item bank and the Cognitive Health Composite were meaningfully associated with participant-reported changes in the areas of attention, multitasking, and memory. Evaluation of change score differences by a variety of clinical indicators demonstrated a small but significant difference in the three TBI-QOL change scores by TBI injury severity grouping. These results support the responsiveness of the TBI-QOL cognition measures in newly injured individuals and provides information on the minimal important differences for the TBI-QOL cognition measures, which can be used for score interpretation by clinicians and researchers seeking patient-reported outcome measures of self-reported cognitive QOL after TBI. (shrink)

Despite the growing profile of ‘implementation science’, its status as a field of study remains ambiguous. Implementation science originates in the evidence-based movement and attempts to broaden the scope of evidence-based medicine to improve ‘clinical effectiveness’ and close the ‘implementation gap’. To achieve this agenda, implementation science draws on methodologies from the social sciences to emphasise coherence between qualitative and quantitative approaches. In so doing, we ask if this is at the expense of ignoring the dominating tendencies of the evidence-based (...) movement and consider if some of the methodologies being drawn on should be considered irreconcilable with evidence-based methodologies. (shrink)

This qualitative cross-sectional survey, undertaken in the antenatal booking clinics of a hospital in central London, explores pregnant women’s responses to routine HIV testing, examines their reasons for declining or accepting the test, and assesses how far their responses fulfil standard criteria for informed consent. Of the 32 women interviewed, only 10 participants were prepared for HIV testing at their booking interview. None of the women viewed themselves as being particularly at risk for HIV infection. The minority of the participants (...) who declined testing differed from those who accepted, by interpreting test acceptance as risky behaviour, privileging the negative outcomes of HIV positivity and expressing an inability to cope with these, should they occur. Troublingly, only a minority of women had a broad understanding of the rationale for the test, and none fulfilled the standard criteria for informed consent. This study suggests that, although routine screening combined with professional recommendation may be successful in increasing uptake, this may be at the cost of eroding informed consent. Protecting third parties from a preventable disease may outweigh the moral duty of respecting autonomy, enshrined in Western bioethical tradition. Nevertheless, such a policy should be made transparent, debated in the public domain and negotiated with women seeking antenatal care. (shrink)

Women in North America have many childbirth options. However, they must make these choices within a complex culture of birthing discourse characterized by competing knowledges and claims regarding the “ideal birth” as medicalized, natural, or woman centered. We interviewed 21 childless women and 22 new mothers to explore their perceptions of choice and birthing. The women’s interviews indicated that their birthing choices are reflective of tensions embedded in normative femininity; conflicting ideas relating to purity, dignity, and the messiness of birth; (...) and contradictions about women’s bodies as heteronormative sites of pleasure and sexuality on one hand and of asexual, selfless sources of maternal nurturance on the other. Finally, the women’s views reflected understandings of moral and normative constructs about selflessness as a core attribute of femininity and motherhood, particularly in terms of enduring pain as the “proper” means of accomplishing the rite of passage to motherhood. Although all the women described tensions between femininity and motherhood, childless women were more likely than mothers to be worried about achieving ideal, heteronormative sexuality and femininity. Likewise, women who have not yet had children and women who have experienced unplanned C-sections were more likely than those who experienced vaginal births to express that C-section births fail to fully accomplish women’s rite of passage to motherhood. (shrink)

Introduction -- The nature of a complex world -- Unpacking complexity -- Have we thought like this before? -- The complexity of complexity theories -- Complexity and the social world -- Complexity and management -- Complexity and strategy -- Complexity and international development -- Complexity and economics -- Final reflections: what we hope you take away from this book.

A self-report questionnaire about involvement in different types of bullying, what behaviours were regarded as bullying, and attitudes towards bullying, bullies and victims was completed by pupils in Year 7 (aged 11/12) through to Year 10 (aged 14/15) ( n = 170). Overall, direct verbal assault was the most commonly reported, and stealing the least frequently reported, type of bullying. For six specific types of bullying investigated, and for a composite measure of all types of bullying, significantly fewer Year 9 (...) pupils than pupils in the other three years reported that they had behaved in these ways in the previous week. No significant sex differences emerged on these measures. These findings suggest that general patterns in bullying activities as a function of age and sex obtained in previous studies do not always hold. Although most pupils indicated that they thought that six out of eight types of behaviour viewed as bullying by researchers should be regarded as bullying, a substantial minority did not. The present study also extended bullying research by examining associations between pupils' definitions and attitudes towards bullying and their reports of bullying others. For one specific type of bullying, 'Forcing people to do things that they don't want to do', significantly fewer pupils who reported that they had behaved in this way than who reported that they had not done so included it in their definition of bullying. A consistent pattern of significant negative correlations of moderate size between attitudes and self-reported involvement in specific types of bullying were obtained. The implications of these findings for those concerned with tackling bullying in schools were discussed. (shrink)

This study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n = 506) and senior students (n = 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and conflict were (...) higher in senior students than in freshman students. Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students. (shrink)

By compiling an experimental method combining both dialectic and rhetoric, 'Dialectic, Rhetoric and Contrast: The Infinite Middle of Meaning' demonstrates how singular meanings can be rendered in a spectrum of 12 repeating concepts that are in a continuum, gradated and symmetrical. The ability to arrange meaning into this pattern opens enquiry into its ontology, and presents meaning as closer to the sensation of colours or musical notes than the bivalent oppositions depicted in classical logic. However, the experiment does not assert (...) that this pattern suggests some sort of constant or absolute principle; instead, it theorises on the ways in which meaning can be considered to be recursive. To explain this, the book explores the concept of contrast itself. No exactitude on the precise existence of contrast can ever be struck because the answer varies infinitely depending upon the scale of measurement used to gauge the meeting point. This characteristic of contrast helps to define a whole new dimension from which sensation, meaning, cognition and consciousness can be analogised to the infinite forms between forms. At a time when the widest consensus in philosophy is the exhaustion of its central themes, the significance of such a hypothesis provides fresh impetus to revise some of the key meanings and concepts underpinning contemporary thought. To do this, the method explores the opposing themes of idealism and realism that run throughout western philosophy from Plato to the Speculative turn. This book will be of interest to professional academic audiences in the humanities and social sciences, from graduates to senior scholars. It will also be an interesting read to anyone wishing to keep abreast of developments in continental philosophy, epistemology, metaphysics, and the sociology of knowledge. (shrink)

This study examined three main issues among 364 primary school children: (1) self?reported levels of perceived safety in classroom and playground, and relationship with teacher, (2) associations between perceived safety in the two contexts and peer reported levels of being bullied, and (3) if relationship with teacher moderated the associations between peer reported levels of being bullied and perceived safety in classroom and playground. Data were collected in individual and small group interviews. Overall, while most participants reported positive relationships with (...) their class teacher, and felt safe in their classroom and in the playground, a substantial minority did not. The correlations between level of being bullied and perceived safety in classroom and playground were significant but of modest size. Relationship with teacher did moderate the correlation for perceived safety in the classroom, but did not do so for perceived safety in the playground. No significant age or sex differences were obtained. The theoretical and practical implications of these findings were discussed. (shrink)

In study 1, the time when aggressive fighting involving 8 and 11 year‐old children took place was examined by means of direct playground observations during lunch‐time recess. There was a tendency, significant in the younger group, for there to have been more fights in the last quarter of recess. In study 2, the causes of fights, the sex of the participants, the proportion of fights that were escalated by other children joining in in a non‐conciliatory way, and the proportion in (...) which children intervened to stop the fights were investigated, again by means of direct playground observations. The most common causes of fights were disputes over some aspect of a rule‐governed game, teasing, retaliations to accidental hurt/injury, and to a lesser extent disputes over space. Most of the fights that were observed involved boys only , and only a minority involved boys and girls or just girls . Most fights were not escalated by other children and most fights did not involve attempts to stop them by other children. In study 3, interview data concerning children's views on fighting are reported. Many children expressed generally negative attitudes towards fighting, and there appeared to be several common ‘barriers’ that deterred children from participating. On the other hand, some children also articulated reasons why they sometimes felt it was necessary to fight. The significance of the results from the three studies for managing children's aggressive behaviour in schools is discussed. (shrink)

In study 1, the time when aggressive fighting involving 8 and 11 year‐old children took place was examined by means of direct playground observations during lunch‐time recess. There was a tendency, significant in the younger group, for there to have been more fights in the last quarter of recess. In study 2, the causes of fights, the sex of the participants, the proportion of fights that were escalated by other children joining in in a non‐conciliatory way, and the proportion in (...) which children intervened to stop the fights were investigated, again by means of direct playground observations. The most common causes of fights were disputes over some aspect of a rule‐governed game, teasing, retaliations to accidental hurt/injury, and to a lesser extent disputes over space. Most of the fights that were observed involved boys only , and only a minority involved boys and girls or just girls . Most fights were not escalated by other children and most fights did not involve attempts to stop them by other children. In study 3, interview data concerning children's views on fighting are reported. Many children expressed generally negative attitudes towards fighting, and there appeared to be several common ‘barriers’ that deterred children from participating. On the other hand, some children also articulated reasons why they sometimes felt it was necessary to fight. The significance of the results from the three studies for managing children's aggressive behaviour in schools is discussed. (shrink)

This paper examines the extent to which parents have absorbed New Right ideas about education and acted accordingly. What emerges is that their commitment to the rhetoric of school choice is strong. However, concepts such as the market and competition are viewed less favourably. An important theme here is the avoidance by parents of any collective agenda in discussing education policy, a factor that may thwart those who attempt to predict their responses to government policy for schools.

Despite three decades of research and development of anti-bullying intervention, this form of systematic aggression continues to be common in schools. The present study investigated if a contributing factor might be that some pupils are unreceptive to teachers? anti-bullying lessons. It invited 8?11?-year-old junior school pupils (N?=?227) to indicate if this was the case, and if so, to give their reasons. Many did indicate being unreceptive (81.9%). The most common reason was ?It is not for me because I don?t bully (...) anyone? (81.9%), followed by ?I know enough about bullying already? (22.9%), ?It is boring or I have heard it all before? (19.4%) and ?Teachers have to do it but they are not really interested in stopping bullying? (14.5%). Some significant age differences emerged. Results are discussed in terms of implications for anti-bullying work in schools. (shrink)

This work presents the concepts of translation and conservative translation between logics. By using algebraic semantics we introduce several conservative translations involving the classical propositional calculus and the many-valued calculi of Post and Lukasiewicz.