This study explored the experiences and views of Dutch nurses on the content, function, dissemination and implementation of their codes of ethics. A total of 39 participants, who differed in age, qualifications, length of work experience and health care setting, took part in focus groups. The findings revealed common unfamiliarity with and a rather implicit use of codes, and negative comments on the growing number of codes available in the Netherlands. Limited dissemination, implementation and functioning of codes of ethics were (...) also identified. The findings were discussed using concepts from the literature, nursing practice and personal experience. (shrink)

Nurses are responsible for the well-being and quality of life of many people, and therefore must meet high standards of technical and ethical competence. The most common form of ethical guidance is a code of ethics/professional practice; however, little research on how codes are viewed or used in practice has been undertaken. This study, carried out in six European countries, explored nurses’ opinions of the content and function of codes and their use in nursing practice. A total of 49 focus (...) groups involving 311 nurses were held. Purposive sampling ensured a mix of participants from a range of specialisms. Qualitative analysis enabled emerging themes to be identified on both national and comparative bases. Most participants had a poor understanding of their codes. They were unfamiliar with the content and believed they have little practical value because of extensive barriers to their effective use. In many countries nursing codes appear to be ‘paper tigers’ with little or no impact; changes are needed in the way they are developed and written, introduced in nurse education, and reinforced/implemented in clinical practice. (shrink)

The ability of 3- and 4-year-old children to disregard advice from an overtly misleading informant was investigated across five studies (total n = 212). Previous studies have documented limitations in young children's ability to reject misleading advice. This study was designed to test the hypothesis that these limitations are primarily due to an inability to reject specific directions that are provided by others, rather than an inability to respond in a way that is opposite to what has been indicated by (...) a cue. In Studies 1 through 4, a puppet identified as The Big Bad Wolf offered advice to participants about which of two boxes contained a hidden sticker. Regardless of the form the advice took, 3-year olds performed poorly by failing to systematically reject it. However, when participants in Study 5 believed they were responding to a mechanical cue rather than the advice of the Wolf, they were better able to reject misleading advice, and individual differences in performance on the primary task were systematically correlated with measures of executive function. Results are interpreted as providing support for the communicative intent hypothesis, which posits that children find it especially difficult to reject deceptive information that they perceive as being intentionally communicated by others. (shrink)

Research findings on addiction are contradictory. According to biographical records and widely used diagnostic manuals, addicts use drugs compulsively, meaning that drug use is out of control and independent of its aversive consequences. This account is supported by studies that show significant heritabilities for alcoholism and other addictions and by laboratory experiments in which repeated administration of addictive drugs caused changes in neural substrates associated with reward. Epidemiological and experimental data, however, show that the consequences of drug consumption can significantly (...) modify drug intake in addicts. The disease model can account for the compulsive features of addiction, but not occasions in which price and punishment reduced drug consumption in addicts. Conversely, learning models of addiction can account for the influence of price and punishment, but not compulsive drug taking. The occasion for this target article is that recent developments in behavioral choice theory resolve the apparent contradictions in the addiction literature. The basic argument includes the following four statements: First, repeated consumption of an addictive drug decreases its future value and the future value of competing activities. Second, the frequency of an activity is a function of its relative (not absolute) value. This implies that an activity that reduces the values of competing behaviors can increase in frequency even if its own value also declines. Third, a recent experiment (Heyman & Tanz 1995) shows that the effective reinforcement contingencies are relative to a frame of reference, and this frame of reference can change so as to favor optimal or suboptimal choice. Fourth, if the frame of reference is local, reinforcement contingencies will favor excessive drug use, but if the frame of reference is global, the reinforcement contingencies will favor controlled drug use. The transition from a global to a local frame of reference explains relapse and other compulsive features of addiction. (shrink)

Reasoning about ulterior motives was investigated among children ages 6–10 years (total N = 119). In each of two studies, participants were told about children who offered gifts to peers who needed help. Each giver chose to present a gift in either a public setting, which is consistent with having an ulterior motive to enhance one's reputation, or in a private setting, which is not consistent with having an ulterior motive. In each study, the 6- to 7-year olds showed no (...) evidence of understanding that the public givers might have ulterior motives, but the 8- to 10-year olds rated the private givers more favorably. In , the older children were more likely than the younger children to refer to impression management when explaining their judgments of the givers. The younger children who mentioned impression management did so to justify a preference for public givers (e.g., by explaining that public givers are nicer because more of their peers will know that they are nice). Results from suggest that developmental change in children's reasoning about intentions and social outcomes contributes to their understanding of ulterior motives. (shrink)

Ordered sheaves on a small quantaloid have been defined in terms of -enriched categorical structures; they form a locally ordered category . The free-cocompletion KZ-doctrine on has , the quantaloid of -modules, as its category of Eilenberg–Moore algebras. In this paper we give an intrinsic description of the Kleisli algebras: we call them the locally principally generated -modules. We deduce that is biequivalent to the 2-category of locally principally generated -modules and left adjoint module morphisms. The example of locally principally (...) generated modules on a locale X is worked out in full detail: relating X-modules to objects of the slice category , we show that ordered sheaves on X correspond with skew local homeomorphisms into X. (shrink)

ABSTRACT Clinicians, researchers and the informed public have come to view addiction as a brain disease. However, in nature even extreme events often reflect normal processes, for instance the principles of plate tectonics explain earthquakes as well as the gradual changes in the face of the earth. In the same way, excessive drug use is predicted by general principles of choice. One of the implications of this result is that drugs do not turn addicts into compulsive drug users; they retain (...) the capacity to say ?no?. In support of the logical implications of the choice theory approach to addiction, research reveals that most addicts quit using drugs by about age 30, that most quit without professional help, that the correlates of quitting are the correlates of decision making, and, according to the most recent epidemiological evidence, the probability of quitting remains constant over time and independent of the onset of dependence. This last result implies that, after an initial period of heavy drug use, remission is independent of any further exposure to drugs. In short, there is much empirical support for the claim that addiction emerges as a function of the rules of everyday choice. (shrink)

The target article emphasizes the relationship between a matching law-based theory of addiction and the disease model of addiction. In contrast, this response emphasizes the relationship between the matching law theory and other behavioral approaches to addiction. The basic difference, I argue, is that the matching law specifies that choice is governed by local reinforcement rates. In contrast, economics says that overall reinforcement rate controls choice, and for other approaches there are other measures or no clear prediction at all. The (...) response also differs from the target article in that there is more emphasis on the finding that stimulus conditions determine whether choice is under local or overall reinforcement rate control. (shrink)

Starting in early childhood, children are socialized to be honest. However, they are also expected to avoid telling the truth in sensitive situations if doing so could be seen as inappropriate or impolite. Across two studies (total N = 358), the reasoning of 3‐ to 5‐year‐old children in such a scenario was investigated by manipulating whether the information in question would be helpful to the recipient. The studies used a reverse rouge paradigm, in which a confederate with a highly salient (...) red mark on her nose asked children whether she looked okay prior to having her picture taken. In Study 1, children tended to tell the truth only if they were able to observe that the mark was temporary and the confederate did not know it was there. In Study 2, children tended to tell the truth only if they were able to observe that the mark could be concealed with makeup. These findings show that for children as young as age 3, decisions about whether to tell the truth are influenced by the likelihood that the information would be helpful to the recipient. (shrink)

On April 1, 2001, I joined the world of Health Information Technology. I started a solo gynecology practice with no income and only expenses. I hired a medical assistant to be my front desk person and my clinical helper. I rented a smaller space than most physicians could use for this purpose because my plan was to use technology to avoid both chart storage as well as the people needed to maintain a medical record library.I hired a hospital employee to (...) put together my “network.” He helped me install my software and set up an automatic backup system. I purchased a single robust desktop computer and brought in an older computer from home for the front desk. I bought a scanner and an inexpensive laser printer. The hardware including a router for my “network” of two computers cost me about $6000. The software, a combined practice management system with an associated EMR requiring only single entry of patient demographics, cost me about $7000. (shrink)

This paper examines Sartre's dualistic ontology in the light of the non-duality asserted by Mahayana Buddhism. In the first section, I show, against the objection of Hazel E. Barnes, that Sartre and Buddhism have comparable theories of consciousness. The second section discusses Steven W. Laycock's use of Zen philosophy to solve the Sartrean metaphysical problem regarding the origin of being for-itself. This solution involves rejecting the ontological priority of being in-itself in favor of the Buddhist understanding of interdependent origination (pratitya-samutpada) (...) and emptiness (sunyata). Finally, I explain how this aspect of Buddhist thought is consistent with Sartre's ontology, thus making an acceptable solution. This consistency is possible if we understand Sartre's ontology as provisionally true in a sense gleaned from the Madhyamika and Yogacara schools of Indian Buddhism, which were influential to the formation of Zen philosophy. (shrink)

A path to personal and community liberation through yoga philosophy on service from yoga teacher, activist, and accessible yoga advocate Jivana Heyman. Yoga is now a mainstream form of exercise across the West, and it is time to address the dissonance between the superficial way yoga is currently being practiced and the depth of yoga's ancient universal spiritual teachings. In this clarion call to action, Jivana Heyman shares the ways that yoga is truly revolutionary--creating an inner revolution in our heart (...) and mind, as well as an outer revolution in the form of service and social justice. He provides us with a framework he calls "Rainbow Mind" to bridge this gap and share a new vision of what yogic enlightenment can look like. Having a Rainbow Mind requires open -heartedness, courage, and a fierce commitment to inclusivity and accessibility. It is about tackling the challenge that Arjuna faces in the Bhagavad Gita--"Should I act?"--and cultivating a state of mind that helps us figure out one of the hardest challenges of life: when to speak up and when to step back. In Yoga Revolution, you will be introduced to the yogic mandate of seva--or acts of service that see, care for, and uplift those around us--as a way to serve the world without losing your way or making it about yourself-all while still maintaining your own self-care. Through practice prompts such as "Failure as a Practice" and stories from yoga teachers who are implementing seva, including Michelle Cassandra Johnson, Octavia Raheem, and Amber Karnes, Heyman shows you what it means to serve, how to serve, and how to reject white supremacy through your service. Our job is not to clear our mind through yoga practice, but rather to expand it so widely that it can embrace the entire universe. (shrink)

A central feature of the Covid-19 pandemic is state differences. Some state Governors closed all but essential businesses, others did not. In some states, most of the population wore face coverings when in public; in other states, <50% wore face coverings. According to journalists, these differences were symptomatic of a politically polarized America. The Big 5 personality factors also cluster at the state level. For example, residents of Utah score high on Conscientiousness and low on Neuroticism, whereas residents of Massachusetts (...) and Connecticut show the opposite pattern. In state-level regressions that controlled for partisan political allegiances, Conscientiousness was a significant predictor of the stringency of state Covid-19 restrictions, whereas Openness was a significant predictor of mask wearing. A number of the predictors were strongly correlated with each other. For example, the correlation coefficient linking Openness with the percentage of Democratic state legislators was r = 0.53. Commonality regression partitions the explained variance between the amount that is unique to each predictor and the amount that is shared among subsets of correlated predictors. This approach revealed that the common variance shared by Conscientiousness, Openness and partisan politics accounted for 34% of the state differences in Covid-19 policy and 35% of the state differences in mask wearing. The results reflect the importance of personality in how Americans have responded to the Covid-19 pandemic. (shrink)

Wegner's conclusion that conscious will is an illusion follows from a key omission in his analysis. Although he describes conscious will as an experience, akin to one of the senses, he omits its objective correlate. The degree to which behavior can be influenced by its consequences (voluntariness) provides an objective correlate for conscious will. With conscious will anchored to voluntariness, the illusion disappears.