Being a healthcare professional in both paediatric and adult hospitals will mean being exposed to human tragedies and stressful events involving conflict, misunderstanding, and moral distress. There are a number of different structured approaches to reflection and discussion designed to support healthcare professionals process and make sense of their feelings and experiences and to mitigate against direct and vicarious trauma. In this paper, we draw from our experience in a large children’s hospital and more broadly from the literature to identify (...) and analyse four established approaches to facilitated reflective discussions. Each of the four approaches seeks to acknowledge the stressful nature of health professional work and to support clinicians from all healthcare professions to develop sustainable skills so they continue to grow and thrive as health professionals. Each approach also has the potential to open up feelings of uncertainty, frustration, sorrow, anguish, and moral distress for participants. We argue, therefore, that in order to avoid unintentionally causing harm, a facilitator should have specific skills required to safely lead the discussion and be able to explain the nature, scope, safe application, and limits of each approach. With reference to a hypothetical but realistic clinical case scenario, we discuss the application and key features of each approach, including the goals, underpinning theory, and methods of facilitation. (shrink)

In response to concerns with existing procedures for measuring strategic control over implicit knowledge in artificial grammar learning , we introduce a more stringent measurement procedure. After two separate training blocks which each consisted of letter strings derived from a different grammar, participants either judged the grammaticality of novel letter strings with respect to only one of these two grammars , or had the target grammar varying randomly from trial to trial which required a higher degree of conscious flexible control. (...) Random variation in the colour and font of letters was introduced to disguise the nature of the rule and reduce explicit learning. Strategic control was observed both in the pure-block and mixed-block conditions, and even among participants who did not realise the rule was based on letter identity. This indicated detailed strategic control in the absence of explicit learning. (shrink)

Abstract: According to certain dispositional accounts of meaning, an agent's meaning is determined by the dispositions that an idealized version of this agent has in optimal conditions. We argue that such attempts cannot properly fix meaning. For even if there is a way to determine which features of an agent should be idealized without appealing to what the agent means, there is no non-circular way to determine how those features should be idealized. We sketch an alternative dispositional account that avoids (...) this problem, according to which an agent's meaning is determined by the dispositions that an abstract version of this agent has in optimal conditions. (shrink)

This essay considers biotrophic cyst and root‐knot nematodes in relation to their biology, host–parasite interactions and molecular genetics. These nematodes have to face the biological consequences of the physical constraints imposed by the soil environment in which they live while their hosts inhabit both above and below ground environments. The two groups of nematodes appear to have adopted radically different solutions to these problems with the result that one group is a host specialist and reproduces sexually while the other has (...) an enormous host range and reproduces by mitotic parthenogenesis. We consider what is known about the modes of parasitism used by these nematodes and how it relates to their host range, including the surprising finding that parasitism genes in both nematode groups have been recruited from bacteria. The nuclear and mitochondrial genomes of these two nematode groups are very different and we consider how these findings relate to the biology of the organisms. BioEssays 30:249–259, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

This paper examines the role which organizational context factors play in individual ethical decision making. Two general propositions are set forth, examining the linkage between ethical work climate and decision making. An agenda for research and the potential implications of the study and practice of managerial ethics are then discussed.

Recognising and responding appropriately to emotions is critical to adaptive psychological functioning. Psychopathic traits (e.g. callous, manipulative, impulsive, antisocial) are related to differences in recognition and response when emotion is conveyed through facial expressions and language. Use of emotional music stimuli represents a promising approach to improve our understanding of the specific emotion processing difficulties underlying psychopathic traits because it decouples recognition of emotion from cues directly conveyed by other people (e.g. facial signals). In Experiment 1, participants listened to clips (...) of emotional music and identified the emotional content (Sample 1, N = 196) or reported on their feelings elicited by the music (Sample 2, N = 197). Participants accurately recognised (t(195) = 32.78, p <.001, d = 4.69) and reported feelings consistent with (t(196) = 7.84, p <.001, d = 1.12) the emotion conveyed in the music. However, psychopathic traits were associated with reduced emotion recognition accuracy (F(1, 191) = 19.39, p <.001) and reduced likelihood of feeling the emotion (F(1, 193) = 35.45, p <.001), particularly for fearful music. In Experiment 2, we replicated findings for broad difficulties with emotion recognition (Sample 3, N = 179) and emotional resonance (Sample 4, N = 199) associated with psychopathic traits. Results offer new insight into emotion recognition and response difficulties that are associated with psychopathic traits. (shrink)

In Norman, Price, and Jones , we argued that the ability to apply two sets of grammar rules flexibly from trial to trial on a “mixed-block” AGL classification task indicated strategic control over knowledge that was less than fully explicit. Jiménez suggested that our results do not in themselves prove that participants learned – and strategically controlled – complex properties of the structures of the grammars, but that they may be accounted for by learning of simple letter frequencies. We (...) first explain why our main conclusions regarding strategic control and conscious awareness are a separable issue to this criticism. We then report additional data which show that our participants’ ability to discriminate between the two grammars was not attributable to differences in simple letter frequencies. (shrink)

Abstractc-Jun N-terminal kinases (JNKs) are intracellular stress-activated signalling molecules, which are controlled by a highly evolutionarily conserved signalling cascade. In mammalian cells, JNKs are regulated by a wide variety of cellular stresses and growth factors and have been implicated in the regulation of remarkably diverse biological processes, such as cell shape changes, immune responses and apoptosis. How can such different stimuli activate the JNK pathway and what roles does JNK play in vivo? Molecular genetic analysis of the Drosophila JNK gene (...) has started to provide answers to these questions, confirming the role of this molecule in development and stress responses and suggesting a conserved function for JNK signalling in processes such as wound healing. Here, we review this work and discuss how future experiments in Drosophila should reveal the cell type-specific mechanisms by which JNKs perform their diverse functions. BioEssays 20:1009–1019, 1998. © 1998 John Wiley & Sons, Inc. (shrink)

The validity of assessment programs is increasingly important in higher education. Existing approaches to assessment are problematic because they eitherfail to provide timely feedback or have suspect measurement issues. We propose a feed-forward assessment model to help overcome these two limitations oftraditional assessment approaches.

"This edition, which replaces the original Loeb edition..., offers text, translation, and annotation that are fully current with modern scholarship"--Front flap of dust jacket, volume 1.

In this commentary we suggest that Fincher & Thornhill's (F&T's) parasite-stress theory of social behaviors and attitudes can be extended to mating behaviors and preferences. We discuss evidence from prior correlational and experimental studies that support this claim. We also reanalyze data from two of those studies using F&T's new parasite stress measures.

The paper is written in response to those who fail to recognize the relation between a patient's mental competency and her state of pain. Some clinicians claim that a proper diagnosis can only be made in the absent of analgesia. Rather, the patient's state of pain directly affects her mental competency and thus her ability to give valid consent. Clinicians should rethink their approach to diagnosis when the patient is in pain.

The legal requirements and justifications for collecting patient-identifiable data without patient consent were examined. The impetus for this arose from legal and ethical issues raised during the development of a population-based disease register. Numerous commentaries and case studies have been discussing the impact of the Data Protection Act 1998 and Caldicott principles of good practice on the uses of personal data. But uncertainty still remains about the legal requirements for processing patient-identifiable data without patient consent for research purposes. This is (...) largely owing to ignorance, or misunderstandings of the implications of the common law duty of confidentiality and section 60 of the Health and Social Care Act 2001. The common law duty of confidentiality states that patient-identifiable data should not be provided to third parties, regardless of compliance with the DPA1998. It is an obligation derived from case law, and is open to interpretation. Compliance with section 60 ensures that collection of patient-identifiable data without patient consent is lawful despite the duty of confidentiality. Fears regarding the duty of confidentiality have resulted in a common misconception that section 60 must be complied with. Although this is not the case, section 60 support does provide the most secure basis in law for collecting such data. Using our own experience in developing a disease register as a backdrop, this article will clarify the procedures, risks and potential costs of applying for section 60 support. (shrink)

Objectives: To develop and pilot a questionnaire based assessment of the importance patients place on medical confidentiality, whether they support disclosure of confidential information to protect third parties, and whether they consider that this would impair full disclosure in medical consultations.Design: Questionnaire administered to 30 consecutive patients attending a GP surgery.Results: Overall patients valued confidentiality, felt that other patients might be deterred from seeking treatment if it were not guaranteed, but did not think that they would withhold information for this (...) reason themselves.Conclusions: When presented with brief details of five clinical situations in which a breach of confidentiality might be considered, a clear majority of subjects believed that doctors should disclose information in two of the situations, but subjects were not confident that doctors would do so. In three situations, about half felt that disclosure was justified—these included the only scenario in which disclosure was clearly mandated by statute. There was little change in patients’ general attitude to confidentiality after considering the scenarios. However, the views expressed were often inconsistent with responses to the clinical scenarios, suggesting that complex opinions were not accurately reflected in the responses. The format of the questionnaire has been amended, and the study will be repeated with other groups of patients. (shrink)

Reprinted, with modification, from Wilson and Keil 1998.

Quantum mechanics (QM) is a favorite area of physics to feature in “science and religion” discussions. We argue that this is at least partly because the arcane results of QM can be deployed to make big theological claims by the linguistic sleight of hand of “register switching”—sliding imperceptibly from technical into everyday language using the same vocabulary. We clarify the discussion by deploying the formal mapping of QM into classical statistical mechanics (CSM) via the mathematical device of “Wick rotation.” This (...) equivalence between QM and CSM suggests caution in claiming distinctiveness for quantum theologizing. After outlining two areas in which quantum insights nevertheless resonate with longstanding themes in theological reflection (hiddenness and visualizability), we suggest that both QM and CSM point to a theology of science in which scientists participate in the divine gaze on creation as imago Dei. (shrink)