Positive family functioning during adolescence is usually studied analyzing parents' competences and children's relationship abilities. We present an instrument for the assessment of parental competence, which encompasses both educational style and transmission of values. The objective of the study was to analyze its factor structure and to assess its value in predicting adolescent outcomes. We recruited 2,459 high school students, aged 12–15, in 40 schools from Spain, Peru, Mexico, and Chile. They responded to the instrument and to other questions (...) regarding lifestyles. Exploratory and confirmatory factor analyses were carried out in order to assess the internal structure of the instrument, and internal consistency of the resulting dimensions was calculated. Finally, regression analyses were performed to establish associations between the parenting dimensions and adolescent outcomes. Factor analyses showed a consistent structure, with good fit indices in the four countries. The final four factors include parenting styles and education in values. Regression analyses showed associations with adolescent outcomes. For example, adolescents' life satisfaction was best predicted by Warmth and Education in fortitude. Practical implications are suggested. (shrink)

Background Developing confident capacity for ethical decision-making is vital in nursing education. However, no tool examines nursing students’ competence in ethical decision-making. Aim This study aimed to develop an Ethical Decision-Making Competence Scale (EDM-CS) to assess ethical care decision-making competencies in nursing students. Participants and research context Original items were obtained by employing a focus group and the Delphi method. A cross-sectional design was used to confirm the items remained on the scale. Additionally, the scale’s reliability and validity (...) were assessed. The EDM-CS was completed by 498 nursing students. An exploratory factor analysis (EFA) was used to examine the factor structure based on data from group 1 ( n = 250). A second-order confirmatory factor analysis (CFA) was used to examine the model’s fitness based on data from group 2 ( n = 248). This study was conducted between August 2022 and July 2023. Ethical considerations The Institutional Review Board of OO Medical University Hospital approved this study’s design and procedure. Results From the original 34 items, nine were deleted in the EFA. Thus, the EDM-CS had 25 items and a four-factor structure (ethical judgement, ethical sensitivity, ethical motivation, and ethical action), which explained 60.97% of the total variance. A second-order CFA identified a second-order factor termed ‘ethical decision-making competence’ with 18 items (root mean square residual = 0.052). The EDM-CS scores correlated significantly and positively with the scores on the Scale of Protective Factor-24 (r = 0.47, p <.001), which indicated good convergent validity. Cronbach’s alpha coefficient of the final EDM-CS was 0.90 and ranged from 0.73 to 0.80 for the four subscales. Discussion and conclusion The EDM-CS was validated to fit the data adequately. It can be used to evaluate clinical nursing students’ ethical decision-making abilities and to develop education strategies to improve their ethical care competence. (shrink)

Background: No studies have examined the underlying structure or predictive validity of the Cognitive Therapy Adherence and Competence Scale. Examining the structure of the CTACS is of great relevance because it could provide information on what constitutes competence in CBT, and whether some underlying factors are more important for predicting treatment outcomes than others. This study investigates the psychometric properties of the Norwegian version of CTACS and its associations with treatment outcomes in a sample of primary care clients (...) who received CBT for anxiety and/or depression.Method: Independent assessors rated audiotaped therapy sessions in a sample of 132 primary care clients, participating in the Prompt Mental Health Care trial. Outcomes were symptoms of anxiety and depression assessed by patient self-report questionnaires. Structural validity was examined by means of confirmatory and exploratory factor analyses, whereas longitudinal associations with treatment outcome were explored by adopting multilevel modeling.Results: No evidence was found for the divergent validity of the constructs competence and adherence as indicated by a very high correlation between these two subscales in CTACS. Regarding reliability, ICCs for the mean score of the full competence scale and its associated subscales were generally good to excellent, although the subscale measuring the quality of the therapeutic relationship was relatively low. Internal consistency was overall acceptable, but our CFA models did not provide an acceptable fit for the pre-specified one-factor and four-factor solutions. EFA results were difficult to interpret, with a sub-optimal three-factor solution providing best model fit and only two meaningful factors [CBT specific skills and session structure ]. Overall, the results indicated no evidence for the scales' predictive validity.Conclusion: Our findings point to several psychometric problems of the CTACS that may limit both its research and clinical utility. The importance of providing empirical evidence for both reliability and validity aspects of scales are discussed and suggestions for future research are provided. (shrink)

The physical activity-related health competence model assumes that individuals require movement competence, control competence, and self-regulation competence to lead a healthy, physically active lifestyle. Although previous research has already established some measurement factors of the three dimensions, no attempts have so far been made to statistically aggregate them on the sub-competence level. Therefore, the goal of the present study was to test two additional factors for PAHCO and subsequently model the second-order structure with two samples (...) from the fields of rehabilitation and prevention. We conducted two questionnaire surveys with persons with multiple sclerosis and teaching students undergoing a basic qualification course in physical education. After performing exploratory items analysis, we used second-order confirmatory factor analysis and multidimensional scaling to investigate whether the scales could be bundled in accordance with the PAHCO model. The CFAs with 10 factors demonstrated a good model fit. In contrast, the second-order analysis with a simple loading structure on the three sub-competencies revealed an unacceptable model fit. Instead, a second-order model variant was preferred [comparative fit index = 0.926, root mean square error of approximation = 0.048, standardized root mean square residual = 0.065] in which body awareness and self-efficacy had theory-conform cross-loadings. The results of multidimensional scaling were in line with the extracted second-order structure. The present results suggested that the extension of the measurement instrument to 10 first-order factors was psychometrically justified for the two populations. The results from the second-order analyses provided the basis for the creation of sum scores, representing manifest indicators of movement competence, control competence, and self-regulation competence. Future studies are needed that cross-validate the extended measurement model with other populations and that relate the sub-competencies of PAHCO to indicators of health-enhancing physical activity. (shrink)

Self-efficacy as applied to language learning encompasses the belief in one’s ability to obtain mastery in a sought-after domain of linguistic competence by committing to goals and maintaining acquired skills. Intercultural communication and effectiveness are of interest to the professional and personal language goals of learners as their progress depends upon a strong motivation to put practical language skills to use when the real-world requires it. Studying or working abroad and engaging in intercultural training are two such contexts that (...) bind research in learner characteristics between applied linguistics and positive psychology as they provide a substrate of concrete interactions through language brokering, transformative experiences characterized by opportunities for changes in self-concept, negotiations with values and authenticity, and forms of interpersonal development underwritten by intercultural communication as an ability. The Self-Efficacy in Intercultural Communication Scale (SEIC) was developed by Peterson et al. (2011) in a sample of educators with overseas sojourning work experience. However, the original study lacked confirmatory analyses of internal and external validity that would provide clarity toward model identification and applicability for research that deals with intercultural communication competence across populations with diverse sample characteristics. A total of 876 teachers (M age = 37.48, SD = 10.81) and 266 university students (M age = 19.48, SD = 0.74) in Japan responded to items from the SEIC instrument. Acceptable model fit was supported for the 8-item short-form as proposed by Peterson et al. (2011). Metric invariance was observed for individuals from a sample of sojourning English language teachers similar to the original validation and a nationwide survey of Japanese teachers of English, offering indications of cross-cultural validity. Degrees of equivalence were also found for the Japanese items as extending fitness for use to students from two universities in Japan. Concurrent validity was supported for self-efficacy in intercultural communication measured by the scale with intercultural effectiveness competencies and speaking and listening self-efficacy constructs used in classroom contexts. Together, this study offers a tool of valid indicators for researchers and practitioners who aim to observe this self-efficacy in positive education or programs that intersect with language learning and intercultural communication. (shrink)

Until recently, struggles for justice proceeded against the background of a taken-for-granted frame: the bounded territorial state. With that "Westphalian" picture of political space assumed by default, the scope of justice was rarely subject to open dispute. Today, however, human-rights activists and international feminists join critics of structural adjustment and the World Trade Organization in challenging the view that justice can only be a domestic relation among fellow citizens. Targeting injustices that cut across borders, they are making the scale of (...) justice an object of explicit struggle. Inspired by these efforts, Nancy Fraser asks: What is the proper frame for theorizing justice? Faced with a plurality of competing scales, how do we know which one is truly just? In exploring these questions, Fraser revises her widely discussed theory of redistribution and recognition. She introduces a third, "political" dimension of justice—representation—and elaborates a new, reflexive type of critical theory that foregrounds injustices of "misframing." Engaging with thinkers such as Jürgen Habermas, John Rawls, Michel Foucault, and Hannah Arendt, she envisions a "postwestphalian" mapping of political space that accommodates transnational solidarity, transborder publicity, and democratic frame-setting, as well as emancipatory projects that cross borders. The result is a sustained reflection on who should count with respect to what in a globalizing world. (shrink)

Indicators of food sovereignty and food democracy center on people having the right and ability to define their food polices and strategies with respect to food culture, food security, sustainability and use of natural resources. Yet food sovereignty, like democracy, exists on multiple and competing scales, and policymakers and citizens often have different agendas and priorities. In passing a ban on the use of genetically-modified seeds in agriculture, Jackson County, Oregon has obtained some measure of food sovereignty. Between 2016 (...) and 2017 ethnographic research was undertaken in rural Southern Oregon where local community and State of Oregon priorities regarding the use of GMO crops are in conflict. This article presents ethnographic research findings about the expression and negotiation of multiple food sovereignties by civil society in rural southern Oregon and the State of Oregon via democratic processes. In particular, these findings illustrate the effects of socio-political power dynamics on local and state acts of food sovereignty, democracy and agrifood policy by analyzing what the different expressions of food sovereignty reveal for its implementation at the local level. (shrink)

Some bioethicists have argued in favor of a sliding scale notion of competence, paternalistically requiring greater competence in relation to more significant risk. I argue against a sliding scale notion, taking issue with the positions of Allen E. Buchanan and Dan W. Brock, Ian Wilkes, and Joel Feinberg. Rejecting arguments that a sliding scale is supported by legal cases, by ordinary usage, and by fallible judgments about competence, I argue in favor of greater evidence of competence (...) when risk is greater. Two clinical cases are examined, both involving amputation, to show that my fixed concept of competence, with a requirement of clearer evidence of competence when risk is high, better accounts for good moral decisions in bioethics. (shrink)

Background:Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty.Objectives:The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi.Methodology:A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of 271 (...) clinical nurses. Data were collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0.Ethical consideration:The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi.Results:The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings.Conclusion:The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence. (shrink)

Predictive Processing (PP) is an increasingly influential neurocognitive-computational framework. PP research has so far focused predominantly on lower level perceptual, motor, and various psychological phenomena. But PP seems to face a “scale-up challenge”: How can it be extended to conceptual thought, language, and other higher cognitive competencies? Compositionality, arguably a central feature of conceptual thought, cannot easily be accounted for in PP because it is not couched in terms of classical symbol processing. I argue, using the example of language, that (...) there is no strong reason to think that PP cannot be scaled up to higher cognition. I suggest that the tacitly assumed common-sense conception of language as Generative Grammar (“folk linguistics”) and its notion of composition leads to the scale-up concerns. Fodor’s Language of Thought Hypothesis (LOTH) plays the role of a cognitive computational paradigm for folk linguistics. Therefore, we do not take LOTH as facing problems with higher cognition, at least with regard to compositionality. But PP can plausibly play the role of a cognitive-computational paradigm for an alternative conception of language, namely Construction Grammar. If Construction Grammar is a plausible alternative to folk linguistics, then PP is not in a worse position than LOTH. (shrink)

The present paper describes a joint action paradigm in which individuals or pairs utilized two computer keys to keep a dot stimulus moving inside a larger rectangle. Members of a pair could neither see nor hear each other. This paradigm allowed us to combine the discrete-trial type dependent variables commonly utilized by representational theorists, with the continuous, temporal dependence variables utilized by dynamical theorists. Analysis revealed that individuals kept the dot in the rectangle longer than dyads and did so by (...) moving it back and forth within the rectangle. Dyads, however, pressed their individual buttons as quickly as possible in order to keep the dot near the middle of the rectangle. These findings indicate that joint action constitutes a multi-scale phenomena that is best investigated via multiple, complementary methodologies versus single-measure, competing theories. (shrink)

If a person is competent to consent to a treatment, is that person necessarily competent to refuse the very same treatment? Risk relativists answer no to this question. If the refusal of a treatment is risky, we may demand a higher level of decision-making capacity to choose this option. The position is known as asymmetry. Risk relativity rests on the possibility of setting variable levels of competence by reference to variable levels of risk. In an excellent 2016 article inJournal (...) of Medical Ethics(JME), Rob Lawlor defends asymmetry of this kind by defending risk relativity, using and developing arguments and approaches found in earlier work such as that of Wilks. He offers what we call the two-scale approach: a scale of risk is to be used to set a standard of competence on a scale of decision-making difficulty. However, can this be done in any rational way? We argue it cannot, and in this sense, and to this extent, risk relativity is a nonsense. (shrink)

The main objective of this study is to identify the socioemotional competencies of adolescents in secondary education who are currently in the first grade of secondary school (school year 2022-2023), which contribute to a better interaction with their peers and environment, in addition to preventing possible risk behaviors. It will be approached from a quantitative approach, with a descriptive scope. The sample consists of 19 students from a private institution, located in the municipality of Guadalupe, Zac. A questionnaire called emociogram (...) was applied through the Habilmind platform, to identify the main characteristics regarding the emotional scale, which in turn is composed of five subscales such as: empathy, assertiveness, interpersonal emotional regulation, teamwork and conflict resolution. The results show us some areas of opportunity that should be emphasized in order to improve the results and thus improve the socioemotional competencies of adolescents. (shrink)

Due to the implementation of global education and global citizenship education in the 21st century, more focus is given to developing teachers’ global competence in English language teaching. This study aims to examine the perceptions of English as a Second Language teachers of global competence integration in English teaching and the professional development programs organized by the Ministry of Education for their global competence development. A web-survey questionnaire was distributed to 172 Malaysian ESL teachers based on selected (...) criteria. The data collected were analyzed descriptively. The main findings indicated that most ESL teachers showed positive perceptions regarding the importance of global competence and integration in English lessons. Although 83.1% of the 172 participants agreed to have attended 10 or more programs related to developing global competence, the descriptive analysis found the ESL teachers’ moderate knowledge and understanding of what constitutes global competence. In contrast, a high agreement was found regarding their perceptions of the importance of global competence in ESL lessons. Also, most respondents revealed the lack of support from the MOE through professional development programs specifically structured to develop ESL teachers’ global competence. The findings served as a template for a larger-scale study that focuses on implementing global competence in the local non-western context. (shrink)

Decision Making Competence (DMC) reflects individual differences in rational responding across several classic behavioral decision-making tasks. Although it has been associated with real-world risk behavior, less is known about the degree to which DMC contributes to specific components of risk attitudes. Utilizing a psychological risk-return framework, we examined the associations between risk attitudes and DMC. Italian community residents (n = 804) completed an online DMC measure, using a subset of the original Adult-DMC battery (A-DMC; Bruine de Bruin, Parker, & (...) Fischhoff, 2007). Participants also completed a self-reported risk attitude measure for three components of risk attitudes (risk-taking, risk perceptions, and expected benefits) across six risk domains. Overall, greater performance on the DMC component scales were inversely, albeit modestly, associated with risk-taking tendencies. Structural equation modeling results revealed that DMC was associated with lower perceived expected benefits for all domains. In contrast, its association with perceived risks was more domain-specific. These analyses also revealed stronger indirect effects for the DMC  expected benefits  risk-taking than the DMC  perceived risk  risk-taking path, especially for risk behaviors that may be considered more antisocial in nature. These results suggest that DMC performance differentially impacts specific components of risk attitudes, and may be more strongly related to the evaluation of expected value of the given behavior. (shrink)

The study of pragmatic competence has gained increasing importance within second language assessment over the last three decades. However, its study in L2 language testing is still scarce. The aim of this paper is to research the extent to which pragmatic competence as defined by the Common European Framework of Reference for Languages (CEFR) has been accommodated in the task descriptions and rating scales of two of the most popular Oral Proficiency Interviews (OPIs) at a C1 level: (...) Cambridge’s Certificate in Advanced English (CAE) and Trinity’s Integrated Skills in English (ISE) III. To carry out this research, OPI tests are first defined, highlighting their differences from L2 pragmatic tests. After pragmatic competence in the CEFR is examined, focusing on the updates in the new descriptors, CAE and ISE III formats, structure and task characteristics are compared, showing that, while the formats and some characteristics are found to differ, the structures and task types are comparable. Finally, we systematically analyse CEFR pragmatic competence in the task skills and rating scale descriptors of both OPIs. The findings show that the task descriptions incorporate mostly aspects of discourse and design competence. Additionally, we find that each OPI is seen to prioritise different aspects of pragmatic competence within their rating scale, with CAE focusing mostly on discourse competence and fluency, and ISE III on functional competence. Our study shows that the tests fail to fully accommodate all aspects of pragmatic competence in the task skills and rating scales, although the aspects they do incorporate follow the CEFR descriptors on pragmatic competence. It also reveals a mismatch between the task competences being tested and the rating scale. To conclude, some research lines are proposed. (shrink)

Introduction: After the outbreak of COVID-19, psychological hotlines functioned as a main channel of psychological assistance and required a large number of professionals to provide services. These hotlines mostly offered a single-use service with short session times and allowed callers to retain anonymity. They functioned as a psychological counseling service for stress experienced in the COVID-19 public health emergency. Hotline psychological counselors must meet special competency requirements. The selection and evaluation tools for recruiting hotline counselors need to be developed.Materials and (...) Methods: The initial scale of competence for psychological hotline counselors was formed by expert evaluation based on theoretical constructs and by using the Delphi method. A link to the questionnaire was sent to a WeChat group of counselors from 36 major psychological hotlines in China in two stages. The questionnaire consisted of questions to elicit basic demographic information and the initial competence scale. In the first phase, 343 valid samples were used to perform exploratory factor analysis. In the second phase, 334 valid samples were used to perform confirmatory factor analysis. The status of the competence of psychological hotline counselors was also analyzed.Results: The factor structure of the Psychological Hotline Counselor Competence Scale was verified and defined in terms of skills, attitude, and knowledge. The results of exploratory factor analysis and confirmatory factor analysis showed that the scale has good reliability and validity. The McDonald’s omega for each factor was calculated. Meanwhile, it was found that the psychological hotline counselors’ self-assessed competence had a high average score.Conclusion: The Competence Scale for Psychological Hotline Counselors for Major Public Emergencies developed in this study has good reliability and validity, and can be a reliable tool for organizing psychological assistance and screening hotline psychological counselors during public emergencies in the future. (shrink)

Both interpersonal and mass media communication is demanding for competence of communicators. The aim of this study was to determine the dimensions of interpersonal communicative competence. First, a total of 23 skills and traits were identified that are by various authors related to interpersonal communicative competence. Then, a research instrument named Interpersonal Communication Competence Inventory (ICCI) was developed for the measurement of those skills and traits. After evaluation of the ICCI scales, their total scores were (...) factor analyzed in an attempt to identify the possible dimensions of interpersonal communication competence. The results of the factor analyses are presented in a schematic model and theoretically elaborated. Finally, more insight is given into various aspects of competent interpersonal communication, and the potential uses of the model presented in this study are outlined. (shrink)

Graduates of doctoral programs are expected to be competent at designing and conducting research independently. Given the level of research competence needed to successfully conduct research, it is important that assessors of doctoral programs have a reliable and validated tool for measuring and tracking perceived research competence among their students and graduates. A high level of research competence is expected for all Ph.D. graduates worldwide, in addition to in all disciplines/fields. Moreover, graduates of Ph.D. programs may complete (...) their studies in one country but then obtain a research position in another country, emphasizing the need to ensure that all doctoral programs are fostering similar levels of research competence. Thus, the purpose of this study was to gather additional evidence for validity and reliability of the Research Competence scale. Specifically, we sought to extend the findings of by adapting the scale, translating it to other languages, and applying the tool with a sample of early stage researchers. Our findings provide initial evidence that the adapted PR-Comp is appropriate for use in three languages and across a variety of disciplines/programs of study. (shrink)

Heterogeneity in mitochondrial content has been previously suggested as a major contributor to cellular noise, with multiple studies indicating its direct involvement in biomedically important cellular phenomena. A recently published dataset explored the connection between mitochondrial functionality and cell physiology, where a non‐linearity between mitochondrial functionality and cell size was found. Using mathematical models, we suggest that a combination of metabolic scaling and a simple model of cell death may account for these observations. However, our findings also suggest the existence (...) of alternative competing hypotheses, such as a non‐linearity between cell death and cell size. While we find that the proposed non‐linear coupling between mitochondrial functionality and cell size provides a compelling alternative to previous attempts to link mitochondrial heterogeneity and cell physiology, we emphasise the need to account for alternative causal variables, including cell cycle, size, mitochondrial density and death, in future studies of mitochondrial physiology. (shrink)

This paper addresses the role of social emotional competence in the emotional and behavioral problems and learning outcomes of preschool children based on their parents’ and teachers’ evaluations. In this study, we compared the perceptions of teachers and parents when evaluating the same child using the multi-informant assessment. First, the associations and differences between both the informant evaluations were investigated. Second, the correlation of the social emotional competence and emotional, and behavioral difficulties among preschool children was analyzed, separately (...) addressing their parents’ and teachers’ evaluations. Third, the role of the preschool children’s social emotional competence in their emotional and behavioral problems, and learning outcomes was investigated building the regression and mediation models. The sample consisted of 507 preschool children and their parents and teachers. Both informants completed the Strengths and Difficulties Questionnaire and Social Skills Improvement System Social-Emotional Learning Brief Scales, and teachers reported on each child’s learning outcomes. When comparing both informants’ evaluations, positive associations were found between teacher and parental evaluations of prosocial behavior and emotional, and behavioral difficulties of preschool children, as well as self-management. Parents evaluated their children higher than teachers in conduct problems, hyperactivity, prosocial behavior, and total difficulty, while teachers evaluated children higher than parents in social emotional competence. According to teachers, the social emotional competence of preschool children was negatively correlated to all difficulty scales, and positively related to the prosocial behavior scale. The demographic variables, as well as parental socioeconomic status and children’s belonging to a vulnerable group were not found to be significantly associated with the preschool children’s learning outcomes. However, social emotional competence remains a significant variable in teacher-rated learning outcomes of preschool children even if sociodemographic variables are controlled. Our findings indicate that a higher level of social emotional competence and lower levels of social, emotional, and behavioral difficulties are related to a higher preschoolers’ academic learning in their teachers’ evaluation. This suggests the importance of early facilitation of social emotional competence as a key factor for academic success and more positive behavioral outcomes. (shrink)

Background The enhancement of nursing care quality is closely related to the clinical competence of nurses, making it a crucial component within health systems. Objective The present study investigated the relationship between nurses’ clinical competence, moral identity, and moral injury during the COVID-19 outbreak. Research design This cross-sectional study was carried out among frontline nurses, using the Moral Identity Questionnaire (MIQ), the Moral Injury Symptom Scale-Healthcare Professionals version (MISS-HP), and the Competency Inventory for Registered Nurse (CIRN) as data (...) collection tools. Participants and research context: The research population for this study consisted of all frontline nurses ( n = 251) employed in a hospital in southern Iran. Sampling was conducted between May 1, 2021 and September 30, 2021, during the COVID-19 outbreak. Ethical considerations The present study received approval from the research ethics committee of Rafsanjan University of Medical Sciences, with project No. 99267 and code of ethics ID No. IR. RUMS.REC.1399.262, dated 15.02.2021. Results According to the study findings, 42.2% of the nurses demonstrated high clinical competence, while 51.4% exhibited moderate clinical competence. The results indicated a positive correlation between moral identity and clinical competence but a negative correlation between moral injury and clinical competence. Furthermore, the variables of moral identity and moral injury were found to predict 10% of the variance in clinical competence. Conclusion According to the results, moral identity and moral injury had an impact on the clinical competence of nurses. Therefore, implementing a program aimed at enhancing moral identity and providing training strategies to address moral injury during crises like the COVID-19 pandemic can lead to improvements in nurses’ clinical competence and the overall quality of care they provide. (shrink)

Resilience and digital skills could be considered necessary competencies for the individual of the twenty-first century, which the current social reality suggests. For this reason we carried out a research in the institution of higher education -IES- Corporación Escuela Tecnológica del Oriente, of Bucaramanga-Colombia, which had a dual purpose: to describe resilience and digital competence in 356 of its students and establish a comparison between the values of these two aspects and those reported in other HEIs in Mexico, using (...) a quantitative, non-experimental, cross-sectional design and descriptive scope approach, the SV-RES Resilience Scale instrument and a Questionnaire for the study of the Digital Competence of Higher Education Students. (shrink)

Background Ethical decision-making confidence develops from clinical expertise and is a core competency for nurse leaders. No tool exists to measure confidence levels in nurse leaders based upon an ethical decision-making framework. Aims The objective of this research was to compare ethical decision-making among nurse leaders in the U.S. and three German-speaking countries in Europe by developing and testing a newly constructed Ethical Decision-Making Confidence (EDMC) scale. Methods The cross-sectional survey included 18 theory-derived questions on ethical decision-making confidence which were (...) used to develop the scale. Participants A convenience sample of nurse leaders from the U.S. and three German-speaking countries in Europe who self-identified as holding a leadership position. Ethical Considerations Ethical approval was given by the IRB Board of a U.S. university. Participation in the survey implied voluntary consent. Results The scale’s item structure dimensionality and subscale’s reliability were analyzed and compared between nurse leaders from all four countries. A principal component analysis (PCA) produced a 15-item bi-dimensional EDMC scale yielding a skill-related (9-item) and a behavior-related (6-item) confidence dimension. EDMC subscales showed good-to-excellent internal consistency. In both subscales, U.S. nurse leaders rated their mean EDMC score higher than their German-speaking counterparts in Europe. Discussion This exploratory study is the first of its kind to focus on nurse leaders’ confidence regarding ethical decision-making in an international context. An overarching factor structure was identified, which is shared by the two samples of nurse leaders and to examine (sub)scales’ psychometric properties. Conclusion This newly developed scale is an effective tool for measuring ethical decision-making confidence in nurse leaders. The promising results of this study should be replicated to ensure validity and reliability of the EDMC scale measuring skill-related and behavior-related concepts and include nurse leaders from various cultural, social, and demographic groups. (shrink)

Like most bioethical discussion, examination of human biobanks has been largely framed in terms of research subjects’ rights, principally informed consent, with some gestures toward public benefits. However, informed consent is for the competent, rights-bearing individual: focussing on the individual, it thus neglects social, economic and even political matters; focussing on the competent rights-bearer, it does not serve situations where consent is plainly inappropriate (eg, the young child) or where coercion can obviously be justified (the criminal). Using the British experience (...) of large-scale biobanking, I argue that the focus on consenting individuals distorts our ways of thinking about biobanks and has serious practical ramifications. This becomes clear if we contrast the case of adult biobanks intended for medical research with two other forms of biobanking. Thus child cohort studies – vital for sound scientific investigation of the interplay of genetics and environment in health – have been very badly funded next to adult studies. On the other hand, forensic databases have attracted massive investment, but little debate – partly owing to a sense that here, at least, is a case where consent is not relevant. Contrasting these central types of biobanking, I will suggest that there are powerful factors at work in limiting ‘ethics’ to individual rights. Projects of this size should direct our attention to more overtly political questions concerning priority setting and organisation of medical research. (shrink)

Scaling out and up are terms increasingly being used to describe a desired expansion of beneficial impacts from agricultural research and rural development. This paper explores strategies for scaling out production and livelihood impacts from proven technologies. We draw on a case study of forages and livestock production in Laos, a Southeast Asian country undergoing rapid economic and agricultural change. A facilitated learning environment stimulated farmers to adapt forages, livestock housing, and animal health practices to their own situations (scaling out). (...) Regular follow-up visits and on-the-job mentoring for extension staff provided institutional support (scaling up). Within 5 years, the number of villages and households using forages and fattening livestock had increased six fold, with a 50% reduction in the time required for farmers to get significant benefits. The paper concludes that scaling out positive impacts from systems change requires field tested and proven technologies, evidence of significant livelihood impacts, fostering of local innovation, competent field staff, effective peer learning, and ongoing institutional support. (shrink)

In the context of item response theory, linking the scales of two measurement points is a prerequisite to examine a change in competence over time. In educational large-scale assessments, non-identical test forms sharing a number of anchor-items are frequently scaled and linked using two− or three-parametric item response models. However, if item pools are limited and/or sample sizes are small to medium, the sparser Rasch model is a suitable alternative regarding the precision of parameter estimation. As the Rasch (...) model implies stricter assumptions about the response process, a violation of these assumptions may manifest as model misfit in form of item discrimination parameters empirically deviating from their fixed value of one. The present simulation study investigated the performance of four IRT linking methods—fixed parameter calibration, mean/mean linking, weighted mean/mean linking, and concurrent calibration—applied to Rasch-scaled data with a small item pool. Moreover, the number of anchor items required in the absence/presence of moderate model misfit was investigated in small to medium sample sizes. Effects on the link outcome were operationalized as bias, relative bias, and root mean square error of the estimated sample mean and variance of the latent variable. In the light of this limited context, concurrent calibration had substantial convergence issues, while the other methods resulted in an overall satisfying and similar parameter recovery—even in the presence of moderate model misfit. Our findings suggest that in case of model misfit, the share of anchor items should exceed 20% as is currently proposed in the literature. Future studies should further investigate the effects of anchor item composition regarding unbalanced model misfit. (shrink)

The present work argues that value is a properly philosophical concept, the study and understanding of which therefore requires philosophical inquiry. It does so by bringing together two, quite different, philosophers: R. G. Collingwood and Dietrich von Hildebrand. From the former, this work takes its account of what differentiates philosophical concepts. From the latter, it takes the concept of importance as differentiated into intrinsic value, objective goodness, and subjective satisfaction. After explicating the distinctive features of philosophical concepts (the intensional overlap (...) of their classes and their situation on a “scale of forms”), it argues that, despite prima facie difficulties, von Hildebrand’s categories of importance can be arrayed as a scale of forms, in which the categories of importance are not only differences in kind, but also differences in degree. The overall result is one illustration of how philosophers can argue for philosophy’s special domain of competence. (shrink)

While translation competence assessment has been playing an increasingly facilitating role in translation teaching and learning, it still failed to offer fine-grained diagnostic feedback based on certain reliable translation competence standards. As such, this study attempted to investigate the feasibility of providing diagnostic information about students’ translation competence by integrating China’s Standards of English with cognitive diagnostic assessment approaches. Under the descriptive parameter framework of CSE translation scales, an attribute pool was established, from which seven attributes (...) were identified based on students’ and experts’ think-aloud protocols. A checklist comprising 20 descriptors was developed from CSE translation scales, with which 458 students’ translation responses were rated by five experts. In addition, a Q-matrix was established by seven experts. By comparing the diagnostic performance of four widely-used cognitive diagnostic models, linear logistic model was selected as the optimal model to generate fine-grained information about students’ translation strengths and weaknesses. Furthermore, relationships among translation competence attributes were discovered and diagnostic results were shown to differ across high and low proficiency groups. The findings can provide insights for translation teaching, learning and assessment. (shrink)

In the nation of Belize, and in particular the south side of Belize City, the main metropolitan area of the nation, significant economic disparities have led to child and adolescent exposure to high rates of violent crime, gang activity, unsafe neighborhoods, sexual, and physical violence. Problems associated with poor Social-Emotional Character Development are especially prevalent among boys. Consequently, valid culture-relevant measures are required that identify problematic behavior for policy-based intervention and evaluation of educational programs designed to ameliorate this problem. The (...) present study demonstrates the application of Exploratory Structural Equation Modeling to existing measures through the investigation of structural validity and generalizability of the Social-Emotional and Character Development Scale with a large sample of children from schools in Belize. Exploratory structural equation modeling results demonstrate the original factor correlations were reduced, providing less biased estimates than confirmatory factor analysis. Moreover, a multi-group Exploratory Structural Equation Modeling analysis illuminates significant differences between latent factor scores of males and females for most factors. Using this newer factor analytic procedure, original factors are reconceptualized to better situate the Social Emotional Character Development Scales into the larger body of Social-Emotional Learning competencies literature. (shrink)

I try to indicate this special quality of classical intelligibility by linking it with the notion of "dual structure," a notion which should not be flattened to mean any sort of intelligibility to those listeners deemed "competent," especially if the term "competence" is used without qualification. Dual structure in music, as I construe it, is an intrastructural system of reference between pairs of discrete semiotic constructs both members of which are in some sense wholly embodied in a given musical (...) structure. These constructs include a general ground of meaning and more particularized semiotic configurations derived from that ground; and because both are present in the musical structure, the relationship between them—the meaning of the music—can be retrieved directly, wholly, and on a general scale. No extrastructural mediating explanation or specialized information or training is needed; the interpreter need merely use the musical equivalent of reason. The archetype of such a system in music seems to be the relation of implication or self-generation that obtains between premise and conclusion within a pure system of logic, which, as described by Kant in his account of theoretical reason, would be universally intelligible. Rose Rosengard Subotnik, assistant professor of music at the University of Chicago, is the author of articles on nineteenth-century music. Her essay which prompted this exchange, "The Cultural Message of Musical Semiology: Some Thoughts on Music, Language, and Criticism since the Enlightenment," appeared in the Summer 1978 issue of Critical Inquiry. (shrink)

Actively open-minded thinking is often used as a proxy for reflective thinking in research on reasoning and related fields. It is associated with less biased reasoning in many types of tasks. However, few studies have examined its psychometric properties and criterion validity. We developed a shortened, 17-item version of the AOT for quicker administration. AOT17 is highly correlated with the original 41-item scale and has highly similar relationships to other thinking dispositions, social competence and supernatural beliefs. Our analyses revealed (...) that the AOT is not a unitary construct, but comprises four distinct dimensions, some of which concern attitudes towards knowledge, and others concern attitudes towards people. This factor structure was replicated in another data-set, and correlations with other measures in four data-sets support the criterion validity of these dimensions. Different dimensions were responsible for the AOT's relationships with other thinking dispositions. (shrink)

This article develops an "ordonomic" approach to business ethics in the age of globalization. Through the use of a three-tiered conceptual framework that distinguishes between the basic game of antagonistic social cooperation, the meta game of rule-setting, and the meta-meta game of rule-finding discourse, we address three questions, the answers to which we believe are crucial to fostering effective business leadership and corporate social responsibility. First, the purpose of business in society is value creation. Companies have a social mandate to (...) organize mutually advantageous cooperation. Second, business ethics should teach the management competencies necessary to fulfill business's societal mandate. These competencies are optimization competence in the basic game of value creation, governance competence in the meta game of (political) rule setting, and the three discourse-related skills of orientation competence, reception competence, and communication competence necessary for engaging in the meta-meta game. Third, companies can help solve global problems through global corporate citizenship if they participate as political and moral actors in rule-setting processes and rule-finding discourse aimed at laying the foundation for value creation on a global scale. (shrink)

Background:Moral courage is required at all levels of nursing. However, there is a need for development of instruments to measure nurses’ moral courage.Objectives:The objective of this study is to develop a scale to measure nurses’ self-assessed moral courage, to evaluate the scale’s psychometric properties, and to briefly describe the current level of nurses’ self-assessed moral courage and associated socio-demographic factors.Research design:In this methodological study, non-experimental, cross-sectional exploratory design was applied. The data were collected using Nurses’ Moral Courage Scale and analysed (...) statistically.Participants and research context:The data were collected from a convenience sample of 482 nurses from four different clinical fields in a major university hospital in Finland for the final testing of the scale. The pilot comprised a convenience sample of 129 nurses.Ethical considerations:The study followed good scientific inquiry guidelines. Ethical approval was obtained from the university ethics committee and permission to conduct the study from the participating hospital.Findings:Psychometric evaluation showed that the 4-sub-scale, 21-item Nurses’ Moral Courage Scale demonstrates good reliability and validity at its current state of development showing a good level of internal consistency for a new scale, the internal consistency values ranging from 0.73 to 0.82 for sub-scales and 0.93 for the total scale, thus well exceeding the recommended Cronbach’s alpha value of >0.7. Principal component analysis and confirmatory factor analysis supported the theoretical construct of Nurses’ Moral Courage Scale. Face validity and expert panel assessments markedly contributed to the relevance of items in establishing content validity.Discussion and conclusion:Nurses’ Moral Courage Scale provides a new generic instrument intended for measuring nurses’ self-assessed moral courage. Recognizing the importance of moral courage as a part of nurses’ moral competence and its assessment offers possibilities to develop interventions and educational programs for enhancement of moral courage. Research should focus on further validation measures of Nurses’ Moral Courage Scale in international contexts. (shrink)

Background: As one of the main participants in health care, nurses are esteemed an important driving force for the vigorous health care development. Studies report that nurses’ proactive personality has positive effects on their job performance; however, this relationship acquires further understanding.Objective: A cross-sectional study was performed to explore the relationship between nurses’ proactive personality and job performance; the mediating role of nurses’ competency and work engagement in this relationship was also evaluated.Methods: The study was performed in a large third-degree (...) general hospital in October 2019, Xi’an, PR, China. A sample of 246 nurses participated in this cross-sectional study. Proactive personality was assessed with the Proactive Personality Questionnaire, job performance was assessed by Heilman three-item measurements, nurse competence was estimated with Nurse Competency Scale, and work engagement was assessed with the Utrecht Work Engagement Scale. The structural equation model was used to test the main hypotheses.Results: Structural equation model analysis revealed that work engagement partially mediated the association between proactive personality and job performance. The serial two-mediator model which was used to explore the association between proactive personality and job performance through competency and work engagement, in sequence, was demonstrated.Conclusion: This study demonstrates that work engagement partially mediated the association between nurses’ proactive personality and their job performance. The serial two-mediator model demonstrated that proactive personality was associated with job performance via competency and work engagement. This study also revealed the critical role of nursing managers in understanding the nurses’ proactive personality, which would facilitate them to enhance the latter’s competency and promote their work engagement. All these will in turn constantly improve the overall quality of nursing and advance professional development of nursing and benefits for patients. (shrink)

The performance of the Mundurucu on the number-space task may exemplify a general competence for drawing analogies between space and other linear dimensions, but Mundurucu participants spontaneously chose number when other dimensions were available. Response placement may not reflect the subjective scale for numbers, but Cantlon et al.'s proposal of a linear scale with scalar variability requires additional hypotheses that are problematic.

Cellular pattern formations of some epithelia are believed to be governed by the direct lateral inhibition rule of cell differentiation. That is, initially equivalent cells are all competent to differentiate, but once a cell has differentiated, the cell inhibits its immediate neighbors from following this pathway. Such a differentiation repeats until all non-inhibited cells have differentiated. The cellular polygonal patterns can be characterized by the numbers of undifferentiated cells and differentiated ones. When the differentiated cells become large in size, the (...) polygonal pattern is deformed since more cells are needed to enclose the large cell. An actual example of such a cellular pattern was examined. The pupal wing epidermis of a butterfly Pieris rapae shows a transition of the equivalent-size cell pattern to the pattern involving large cells. The process of the transition was analyzed by using the method of weighted Voronoi tessellation that is useful for treatment of irregularly sized polygons. The analysis supported that the pattern transition of the early stage of the pupal wing epidermis is governed by the lateral inhibition rule. The differentiation takes place in order of largeness, but not smallness, of the apical polygonal area in the differentiating region of the pupal wing. (shrink)

Emerging research has highlighted the utility of measuring individual differences in decision-making competence (DMC), showing that consistently following normatively rational principles is associated with positive psychosocial and health behaviors. From another level of analysis, functional theories of personality suggest that broad trait dimensions represent variation in underlying self-regulatory systems, providing a mechanistic account for robust associations between traits and similar life outcomes. Yet, the degree to which broad dispositional personality dimensions predict global tendencies to respond rationally is less understood. (...) In a large online community sample (N = 804), we tested the associations between HEXACO personality dimensions, a 6-factor structural trait model, and a subset of DMC indicators (Applying Decision Rules, Resistance to Framing, Recognizing Social Norms, and Consistency in Risk Perception). Additionally, we examined gender differences across the DMC, first considering the potential for measurement non-invariance across groups for the DMC. We observed partial measurement invariance between men and women; only the Applying Decision Rules scale showed evidence of differential functioning across groups. Controlling for these differences, analyses revealed that higher Conscientiousness, Honesty/Humility, and Openness were associated with higher DMC scores. In contrast, Emotionality and Extraversion demonstrated gender-specific associations. Speci... (shrink)

U novije vrijeme smatra se da učitelji imaju ključnu ulogu u suočavanju s problemom vršnjačkog nasilja, a za kvalitetne intervencije važna je kompetentnost učitelja. Cilj ovog istraživanja je ispitati odnos kompetentnosti i percipirane ozbiljnosti nasilne situacije u predviđanju intervencija učitelja u slučajevima vršnjačkog nasilja. Istraživanje je provedeno na nacionalno reprezentativnom uzorku učitelja osnovnih škola u Republici Hrvatskoj, prosječne dobi 43 godine. Za prikupljanje podataka, uz upitnik sociodemografskih karakteristika, korištene su Vinjete te Skala samoprocjene kompetentnosti za rad učitelja na problemima vršnjačkog (...) nasilja. Uz analizu temeljnih odrednica kompetentnosti utvrđeno je da će učitelji koji su kompetentniji procjenjivati nasilje ozbiljnije od svojih manje kompetentnih kolega, a oni koji nasilje percipiraju ozbiljnije češće će i intervenirati. Rezultati pokazuju da kompetentnost ima značajnu prediktivnu ulogu u predviđanju intervencija, a u tom odnosu ozbiljnost nasilja ima moderatorski efekt. Najnižu vjerojatnost intervencije imaju učitelji s niskom kompetentnosti i niskom percepcijom ozbiljnosti nasilja, a najvišu vjerojatnost intervencije imaju učitelji koji imaju visoke razine kompetentnosti i procjenjuju nasilje ozbiljnim. Uz temeljno određenje kompetentnosti, ovaj rad nudi i relevantne smjernice za edukaciju učitelja. In recent times, teachers are considered to play a key role in dealing with the problem of peer violence and their competence is very important for quality interventions. The aim of this study was to examine the relationship between competence and perceived severity of a violent situation in predicting teacher intervention in cases of peer violence. The research was conducted on a nationally representative sample of primary school teachers in the Republic of Croatia, average age 43 years. In addition to the socio-demographic characteristics questionnaire, data was collected via Vignettes and the Self- Assessment Competence Scale for Teachers’ Work on Peer Violence Problems. In addition to the analysis of the basic determinants of competence, it was found that teachers who are more competent will assess violence somewhat more seriously than their less competent colleagues, and those who perceive violence more seriously will also intervene more often. The results show that competence has a significant predictive role in predicting interventions, and in this respect the severity of violence has a moderating effect. Teachers with low competence and low perception of the severity of violence have the lowest probability of intervention, and teachers with high levels of competence who assess violence as serious have the highest probability of intervention. (shrink)

Relevant research shows teachers’ “psychological power” plays a more essential role in promoting their professional development compared with the powers provided by various external factors, and it is therefore held that exploring college English teachers’ individual psychological power is of great significance. To this end, this study investigated college English teachers’ psychological empowerment via the development and validation of CETPE’s scale. Based on our literature review on psychological empowerment and analysis of teachers professional development’s status quo, we made a working (...) definition of CETPE as a system involving perception of their occupation, sense of competence, experiencing of autonomy, judgment of their impact and understanding of their status. In our study, firstly the literature review and the interview with 17 college English teachers were adopted to conceptualize the dimensions of CETPE, and an exploratory factor analysis of data was conducted from 227 college English teachers and then the subsequent confirmatory factor analysis of data collected from another sample of 1030 generated 15 items belonging to five factors. The findings reveal that CETPE is systematically composed of teachers’ positive perception and experience of work meaningfulness, teaching autonomy, occupational competence, professional impact and social status. This study provides a new path for teachers’ professional development via strengthening their intrinsic driving force and thus helps improve the college English teaching effects. (shrink)

All epistemic agents physically consist of parts that must somehow comprise an integrated cognitive self. Biological individuals consist of subunits (organs, cells, molecular networks) that are themselves complex and competent in their own context. How do coherent biological Individuals result from the activity of smaller sub-agents? To understand the evolution and function of metazoan bodies and minds, it is essential to conceptually explore the origin of multicellularity and the scaling of the basal cognition of individual cells into a coherent larger (...) organism. In this paper I synthesize ideas in cognitive science, evolutionary biology, and developmental physiology toward a hypothesis about the origin of Individuality: “Scale-Free Cognition”. I propose a fundamental definition of an Individual based on the ability to pursue goals at an appropriate level of scale and organization, and suggest a formalism for defining and comparing the cognitive capacities of highly diverse types of agents. Any Self is demarcated by a computational surface – the spatio-temporal boundary of events that it can measure, model, and try to affect. This surface sets a functional boundary - a cognitive “light cone” which defines the scale and limits of its cognition. I hypothesize that higher-level goal-directed activity and agency, resulting in larger cognitive boundaries, evolve from the primal homeostatic drive of living things to reduce stress – the difference between current conditions and life-optimal conditions. The mechanisms of developmental bioelectricity - the ability of all cells to form electrical networks that process information - suggests a plausible set of gradual evolutionary steps that naturally lead from physiological homeostasis in single cells to memory, prediction, and ultimately complex cognitive agents, via scale-up of the drive of infotaxis. Recent data on the molecular mechanisms of pre-neural bioelectricity suggest a model of how increasingly sophisticated cognitive functions emerge smoothly from cell-cell communication used to guide embryogenesis and regeneration. This set of hypotheses provides a novel perspective on numerous phenomena, such as cancer, and makes several unique, testable predictions for interdisciplinary research that have implications not only for evolutionary developmental biology but also for biomedicine and perhaps artificial intelligence and exobiology. (shrink)

The SSIS SEL Brief Scales are multi-informant measures that were developed to efficiently assess the SEL competencies of school-age youth in the United States. Recently, the SSIS SELb was translated into multiple languages for use in a multi-site study across six European countries. The purpose of the current study was to examine concurrent and predictive evidence for the SEL Composite scores from the translated versions of the SSIS SELb Scales. Results indicated that SSIS SELb Composite scores demonstrated expected (...) positive concurrent and predictive relationships with scores from the Connor-Davidson Resilience Scale and negative relationships with scores from the problem behavior scales of the Strengths and Difficulties Questionnaire. Although there were a few exceptions, these patterns generally were consistent across informants and samples providing initial validity evidence for the Composite score from the translated versions of the SSIS SELb Scales. Limitations and future research directions are discussed. (shrink)

Decision-making competence refers to the ability to make better decisions, as defined by decision-making principles posited by models of rational choice. The adult decision-making competence (A-DMC) scale is a relatively mature evaluation tool used for decision-making competence. However, the A-DMC is yet far from other mature psychological evaluation tools, and especially the structure of A-DMC remains unclear. In the current study, we estimated a regularized partial correlation network of decision-making competence in a Chinese sample consisting of (...) 339 adults who were evaluated by the A-DMC, and then the centrality indicators were calculated. The results revealed that all nodes of the decision-making competence networks are positively associated, except for the association of resistance to framing (RF) and resistance to sunk costs (SC). The strongest edge was between RF and applying decision rules (DR; regularized partial correlation = 0.37). The centrality indicators of RF and applying DR were highest, revealing that these two variables may play important roles in the decision-making competence network. Our study conceptualizes the decision-making competence from network perspectives, so as to provide some insights for future researches. (shrink)

Background: Clinical ethics support instruments aim to support healthcare professionals in dealing with moral challenges in clinical practice. CURA is a relatively new instrument tailored to the wishes and needs of healthcare professionals in palliative care, especially nurses. It aims to foster their moral resilience and moral competences. Aim: To investigate the effects of using CURA on healthcare professionals regarding their Moral Resilience and Moral Competences. Design: Single group pre-/post-test design with two questionnaires. Methods: Questionnaires used were the Rushton Moral (...) Resilience Scale measuring Moral Resilience and the Euro-MCD, measuring Moral Competences. Respondents mainly consisted of nurses and nurse assistants who used CURA in daily practice. Forty-seven respondents contributed to both pre- and post-test with 18 months between both tests. Analysis was done using descriptive statistics and Wilcoxon signed rank tests. This study followed the SQUIRE checklist. Ethical considerations: This study was approved by the Institutional Review Board of Amsterdam UMC. Informed consent was obtained from all respondents. Results: The total Moral Resilience score and the scores of two subscales of the RMRS, that is, Responses to Moral Adversity and Relational Integrity, increased significantly. All subscales of the Euro-MCD increased significantly at posttest. Using CURA more often did not lead to significant higher scores on most (sub) scales. Conclusion: This study indicates that CURA can be used to foster moral resilience and moral competences of healthcare professionals. CURA therefore is a promising instrument to support healthcare professionals in dealing with moral challenges in everyday practice. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:"But I Don’t Feel It":Values and Emotions in the Assessment of Competence in Patients With Anorexia NervosaJochen Vollmann (bio)Keywordscompetence assessment, mental capacity, informed consent, psychiatry, anorexia nervosaThe respect of the self-determination of patients obliges physicians to obtain the patient's consent before providing medical treatment. One important condition for a valid informed consent is the patient's competence to make autonomous health care decisions. Therefore, a proper assessment of (...) competence to make health care decisions is crucial particularly in patients with mental disorders (Vollmann 2000; Helmchen and Vollmann 2001). In recent years, several empirical studies on the assessment of competence in patients suffering from different mental disorders have been performed using the MacArthur Competence Assessment Tool-Treatment (MacCAT-T; Grisso and Appelbaum1998). This assessment tool is based on legal standards of competence such as understanding, reasoning, appreciation, and expressing a choice. Since its first publication, the MacCAT-T has been widely accepted as a "gold standard" of competence assessment in the psychiatric literature. In recent years the MacCAT-T has been applied to patients suffering from depression, schizophrenia, dementia, angina pectoris, and normal controls (for overview, see Welie [2001] and Bauer and Vollmann [2002]).Tan and her colleagues (2006) use the MacCAT-T the first time to assess competence to make treatment decisions in patients with anorexia nervosa. Coming from clinical practice, the authors have noticed that the MacCAT-T might not work in this group of patients. Therefore, they use semi-structured interviews in addition to the MacCAT-T to identify aspects of thinking that might be relevant to the issue of competence to refuse treatment. They use grounded theory techniques for a qualitative analysis of the data as well as five brief, self-administered questionnaires to ascertain levels of psychopathology.The results of the study show that anorexia nervosa can have complex and variable effects on concentration, beliefs, and thought processing without affecting the ability to perform well on the MacCAT-T. At the same time, participants also report a change in their value system as well as in their personal identity. The authors argue that the results of their studies suggest that the competence to refuse treatment might be compromised in [End Page 289] people with anorexia nervosa in ways that are not captured by the MacCAT-T. This is an interesting finding in patients with anorexia nervosa, because in all other studies with patients suffering from mental disorders such as dementia, depression, and schizophrenia, the MacCAT-T identified more patients as limited in their competence to make health care decisions in comparison with other methods of competence assessment such as clinical judgment (Vollmann et al. 2003). The authors argue on the basis on their qualitative, semistructured interviews that anorexia nervosa–specific difficulties with a thought process and the change of values are missed by the MacCAT-T.Furthermore, Tan and her associated could not find a relationship between the participants' scores on the psychopathological scales, the MacCAT-T scores, and their difficulties expressed during the qualitative interviews, although the small size of the study precludes statistical analysis. In an earlier study, clinical dementia scales but not neuropsychological testing correlated with formal (MacCAT-T) and clinical assessment of competence. Therefore, psychopathological factors might play a different role in different subgroups of patients suffering from different mental problems. However, the idea of an objective neuropsychological model of competence assessment, again, finds no support in the presented empirical data.The qualitative data from patients with anorexia nervosa underline the problem of the cognitive bias of the MacCAT-T assessment and the illusion of value-free categories. It has been argued that the cognitive focus for the MacCAT-T is in itself a normative convention and that the MacCAT-T is missing the complexity of the process to make health care decisions in real life. Therefore, values and emotions should be considered in addition to cognitive functions in assessing competence to make health care decisions (Breden and Vollmann 2004; see also "Mental capacity" 2004). Although many authors agree that the cognitive approach of capacity assessment is important but not sufficient for the assessment of competence to make health care decisions, it remains an... (shrink)

Based on the conception of life and semiosis as co-extensive an attempt is given to classify cognitive and communicative potentials of species according to the plasticity and articulatory sophistication they exhibit. A clear distinction is drawn between semiosis and perception, where perception is seen as a high-level activity, an integrated product of a multitude of semiotic interactions inside or between bodies. Previous attempts at finding progressive trends in evolution that might justify a scaling of species from primitive to advanced levels (...) have not met with much success, but when evolution is considered in the light of semiosis such a scaling immediately catches the eye. The main purpose of this paper is to suggest a scaling of this progression in semiotic freedom into a series of distinct steps. The elleven steps suggested are: 1) molecular recognition, 2) prokaryote-eukaryote transformation, 3) division of labor in multicellular organisms, 4) from irritability to phenotypic plasticity, 5) sense perception, 6) behavioral choice, 7) active information gathering, 8) collaboration, deception, 9) learning and social intelligence, 10) sentience, 11) consciousness. In light of this, the paper finally discusses the conceptual framework for biosemiotic evolution. The evolution of biosemiotic capabilities does not take the form of an ongoing composition of simple signs into composite wholes. Rather, it takes the shape of the increasing subdivision and control of a primitive, holophrastic perception-action circuit already committed to “proto-propositions” reliably guiding action already in the most primitive species. (shrink)