Religiosity and Ethical Ideology of Physicians: A Cross-Cultural Study

In this study of ethical ideology and religiosity, 1,255 physicians from Canada, China, Ireland, India, Japan and Thailand participated. Forsyth’s (1980) Ethical Position Questionnaire and Rohrbaugh and Jessor’s (J Pers 43:136–155, 1975) Religiosity Measure were used as the survey instruments. The results demonstrated that physicians from India, Thailand and China reported significantly higher rates of idealism than physicians from Canada and Japan. India, Thailand and China also scored significantly higher than Ireland. Physicians from Japan and India reported significantly higher rates of relativism than physicians from Canada, Ireland, Thailand and China. Physicians from China also reported higher rates of relativism than physicians from Canada, Ireland and Thailand. Overall, religiosity was positively associated with idealism and negatively associated with relativism. This study is the first to explore the differences between ethical ideology and religiosity among physicians in an international setting as well as the relationship between these two constructs. Both religiosity and ethical ideology are extremely generalized, and the extent to which they may impact the actual professional behaviour of physicians is unknown. This paper sets up a point of departure for future research that could investigate the extent to which physicians actually employ their religious and/or ethical orientation to solve ambiguous medical decisions.     

Explaining the socioeconomic well-being of immigrants and returned migrants: An econometric analysis of the Hong Kong and Canadian censuses of 2001

This article focuses on an explanation of return migration to Hong Kong based not on the economic failure of Hong Kong immigrants, but on their strategic vision to accumulate human capital while abroad, which they then exploit on their return. We found that Hong Kong returnees with degrees earned abroad in 2001 constituted about 20% of the highly educated Hong-Kong resident group, with the largest flow emanating from Canada. An econometric investigation revealed that both the income and the odds of being a manager were significantly higher for returned migrants than for their counterparts who remained in Canada. Our findings suggests that this return migration is motivated by returnees’ ability to exploit their accumulated foreign transnational capital in the context of Hong Kong. Cet article repose sur une explication de la migration de retour vers Hong Kong, motivée non pas par la faillite économique des immigrants de Hong Kong, mais plutôt par leur vision stratégique consistant à accumuler le capital humain pendant leur séjour à l’étranger pour ensuite l’exploiter lors de leur retour. Nous avons constaté qu’à Hong Kong, le groupe de gens très éduqués était constitué, à environ 20%, de rapatriés détenant des diplômes obtenus à l’étranger, et que la plupart d’entre eux revenaient du Canada. Une analyse économiétrique a révélé que, par rapport aux migrants qui étaient restés au Canada, ceux qui étaient retournés à Hong Kong jouissaient d’un revenu plus ?evé et d’une meilleure chance de devenir cadres. Nos résultats permettent de conclure que cette migration de retour est motivée par la capacité des migrants de mettre á profit, dans le contexte de Hong Kong leur capital transnational accumulé à l’étranger.     

Is This Relevant? Physician Perceptions,Clinical Relevance,and Religious Content in Clinical Interactions

Despite wide support among physicians for practicing patient‐centered care, clinical interactions are primarily driven by physicians’ perception of relevance. While some will perceive a connection between religion and patient health, this relevance will be less apparent for others. I argue that physician responses when religious/spiritual topics come up during clinical interactions will depend on their own religious/spiritual background. The more central religion is for the physician, the greater his or her perception of religion's impact on health outcomes and his or her inclusion of religion/spirituality within clinical interactions. Using a nationally representative sample of physicians in the United States and mediated path models, I estimate models for five different physician actions to evaluate these relationships. I find that a physician's religious background is strongly associated with whether or not he or she thinks religion impacts health outcomes, which is strongly predictive of inclusion. I also find that not all of the association between inclusion and physicians’ religious background is mediated by thinking religion impacts health outcomes. Issues of religion's relevance for medicine are important to the degree that religious beliefs are an important dimension of patients’ lives.     

Enacting Actuarial Fairness in Insurance: From Fair Discrimination to Behaviour-based Fairness

ABSTRACT

In line with developments in the personalisation of risk, the idea that insurance products should above all be ‘fair’ to the policyholders is increasingly voiced by commentators. The performativity thesis in Science and Technology Studies usually used to study economic markets can be used to investigate different enactments of ‘actuarial fairness’ in insurance practice. Actuarial fairness functions as a technical economic concept and was coined by the neoclassical micro-economist Kenneth Arrow (1921–2017). Faced with anti-discrimination legislation, the insurance industry has, since the 1980s, advanced the principle of actuarial fairness to legitimise their medico-actuarial technologies to discriminate between risk groups. In the absence of this actuarial fairness, it is assumed that dynamics of adverse selection—derived from neoclassical assumptions about economic actors— will result in the bankruptcy of insurance providers. The paradigmatic case of Fairzekering, a showcase of contemporary behaviour-based personalisation in car insurance, demonstrates an important shift in how actuarial fairness is enacted through behaviour-based calculative devices. Here, policyholders are enacted as being personally in control of their driving style while an interactive discount-infrastructure is set up to provide real-time feedback to incentivize policyholders towards ‘good behaviour.’ This enactment of behaviour-based fairness simultaneously implies a shift in the enactment of the economic actors involved, constitutive of the making of new economic ideas in behavioural economics.     

Physicians’ views on men's mental health and the role of counselling services – a pilot study

This pilot study aimed to explore how physicians understand men's avoidance of mental health counselling services and to elicit physicians’ views on pairing mental health assessment with routine physical examination. Initially, physicians’ views on men's avoidance of mental health counselling services were explored through a focus group. A short survey exploring views on pairing mental health assessment with a routine physical examination was then developed and sent to 125 physicians at a local medical centre. Physicians discussions indicated that male socialisation processes, the stigma of needing help, and ignorance about counselling sessions, all contribute to men's avoidance of mental health counselling services. The survey results suggest that combining a mental health assessment with an annual physical examination was viewed positively by most physicians (80%), that they would encourage this approach (75%), and would appreciate the support of counselling services in this process (80%). However, these survey results were influenced by the age and sex of the physician. The focus group suggestion to pair mental health assessments with routine medical examinations, with support from counselling services, was viewed by most physicians as a positive way to engage men. Preliminary services could be established that utilise this approach and examine its efficacy.     

“I am the Author and Must Take Full Responsibility”: Abraham Verghese,Physicians as the Storytellers of the Body,and the Renewal of Medicine

Abraham Verghese proposes to renew medicine by training physicians to read the right texts—literary fiction and patients' bodies—with skilled attention. Analyzing Verghese's proposal with reference to Foucault's idea of the "clinical gaze," I find that Verghese conceives of patients as texts that only physicians can read, meaning that physicians become the storytellers of the bodies, lives, and deaths of the people they meet as patients. I conclude that Verghese's project is unsustainable and alternatively propose thinking analogically of physicians as ship captains who maintain therapeutic distance to reopen interpretative spaces for communities outside of medicine.     

Chinese immigrants in vancouver: Quo vadis?

This article reports findings from a study carried out in Vancouver that examined the settlement and adaptation experiences of Chinese immigrants. The findings reveal that non-economic reasons such as the environment, education, and citizenship constituted the primary motivations for Chinese immigrants to move to Canada. Employment and language facilities were the most frequently cited barriers inhibiting their integration into the Vancouver social and economic spheres. Their poor economic performances, coupled with the devaluation of both their acquired Chinese educational qualifications and labour market experience, have hindered integration and increased dissatisfaction with their lives in Canada. Given the logic of our posited triangular migration model, we argue that this dissatisfaction will encourage Chinese emigration from Vancouver. Cet article présente les conclusions d’une étude effectuée à Vancouver et portant sur l’établissement et ládaptation des immigrants chinois. Les réesultate indiquent que ce sont surtout des raisons non économiques - l’environnement, ’éducation et la citoyenneté - qui ont poussé les immigrants chinois á venir au Canada. Le marché du travail et les ressources linguistiques figuraient parmi les facteurs les plus souvent évoqués comme obstacles à leur intégration aux milieux sociaux et économiques de Vancouver. Leurs faibles rendements économiques, conjuguées à la dépréciation de leur scolorité et leurs expériences professionnelles chinoises, ont nui à leur intégration tout en augmentant leur insatisfaction face à leur vie au Canada. Suivant la logique qui sous-tend notre modèle triangulaire de migration, nous maintenons que cette insatisfaction poussera la population chinoise à émigrer de Vancouver.     

Barriers and Facilitators to Professional Licensure and Certification Testing in Canada: Perspectives of Internationally Educated Professionals

Testing is an essential component of professional licensure and certification, which serves as a powerful decision-making tool to include or exclude internationally educated professionals from their respective professions in Canada. This study examines the role that testing plays in professional licensure and certification from the perspectives of newly arrived internationally educated professionals (IEPs) in four professions: teachers, engineers, nurses, and medical doctors. The study was conducted in Kingston and Windsor, ON, Canada. Data were collected through face to face interviews. The findings indicate both internal and external factors are associated with the testing process which impact whether IEPs can continue to practice and can contribute to Canada’s long-term social and economic goals.     

Socio-Cultural Determinants of Physical Activity among Latin American Immigrant Women in Alberta,Canada

Acculturation has been associated with decreased physical activity among immigrants. This study assessed the process of changing physical activity patterns within the context of Latin American immigrant women’s migration experiences to Canada. Using the ecological model of health promotion, we applied a mixed methods research design. Thirty-six Latin American immigrant women, 18 recent (<10 years in Canada) and 18 non-recent (>10 years in Canada), participated. Six focus groups and 14 in-depth individual interviews were conducted. The Godin Leisure-Time Exercise Questionnaire was administered. Overall, 86 % of the participants reported gaining weight since coming to Canada. Participants reported becoming more sedentary upon arriving in Canada. Only 27.3 % of recent and 41.7 % of non-recent immigrant women were considered sufficiently physically active. Lack of time, resources, social support, and migration stress were identified as key barriers to physical activity. Migration stress associated with social integration barriers strongly influence physical activity among Latin American immigrant women.     

Disclosing Fathers’ HIV Infection to their Sons in Togo

This study examined the views of parents living with HIV/AIDS (PLWHA) and healthcare providers in Togo, on the appropriateness of HIV-infected fathers disclosing their serostatus to their sons. In early 2016, 177 PLWHA (95 mothers and 82 fathers) and 123 healthcare providers (20 physicians, 24 nurses, 41 nurse’s aides, 13 health counsellors, and 25 psychologists) judged the appropriateness of disclosure in 48 scenarios. These scenarios were composed by systematically varying the levels of four factors derived from previous studies on disclosure of bad news: the visibility of symptoms, the son’s level of psychological robustness, the son’s age, and whether the mother was involved in the decision. Seven qualitatively different positions were found: Depends on Son’s Maturity (20%), Depends on Mother’s Involvement in the Decision and Son’s Maturity (19%), Always Quite Appropriate (16%), Depends on Visibility of Symptoms and Son’s Maturity (15%), Depends on Mother’s Involvement in the Decision (14%), Depends on Son’s Age (9%), and Don’t Tell to Adult Son (7%). Healthcare providers (59% of nurses and 25% of physicians) were more likely than PLWHA (10%) to endorse the view that disclosure is Always Quite Appropriate. These findings suggest that interventions to encourage and support parental HIV disclosure in Togo, and possibly in other sub-Saharan African countries, must not be “one size fits all”, but must be tailored in design and implementation to address parents’ differing views, fears, and needs.     

Factors related to the use of pedestrian bridges in university students of Honduras

Considering that deaths and injuries due to run overs near pedestrian bridges (PB) are preventable events, this research aims to analyze the factors related to the use of pedestrian bridges in students of a public university of Honduras. This was made through a quantitative methodology; 330 questionnaires were applied to a sample of university students. Results suggest that 17.27% of the respondents don’t use the bridge. Most respondents (62.42%) believe it’s faster to cross the street and that using the bridge is tiresome (79.90%). Pedestrian bridges are also considered to be unsafe places, prone to robberies. Pearson’s r coefficient determined that this belief is significantly associated with the perception of cleanliness, quality of the infrastructure and illumination. There is a correlation between stress and considering the use of the bridge as a tiresome activity. A logistic regression model determined that significant variables explained the use of the PB included: being in a hurry, believing it’s faster to cross the street, thinking that PBs have a bad infrastructure, laziness and thinking that using the PB is tiresome, all of them reducing the chance that someone will use the bridge. On the other hand, non-significant variables in the model included: age, considering that using the PB is stressful, thinking that crossing the street is stressful, thinking PBs have good illumination. Safety related variables were not able to discriminate between users and non-users. These results are discussed in the light of previous research and their implication for public policy and future research.     

Breast Cancer Risk Assessment at the Time of Screening Mammography: Perceptions and Clinical Management Outcomes for Women at High Risk

The purpose of this study was to evaluate the utility of a breast cancer risk assessment (BCRA) at the time of screening mammogram. Women whose BCRA indicated a high risk for cancer received a letter with instructions for breast health care and genetic counseling if appropriate. After 6 months this group received surveys to evaluate their risk perception and their recall of, and compliance with, recommendations. We also explored the impact of other variables such as a recommendation for genetic counseling and physician communication with the women. After the BCRA, the majority of high risk women reported no change in their perceived risk of cancer. A woman’s perceived risk of cancer after a BCRA was significantly associated with her recall of recommendations for breast health care, but not with compliance. A recommendation for genetic counseling was not significantly related to women’s perceived risk of cancer after the BCRA. Ten percent of women who should have obtained genetic counseling actually completed an appointment. Women who discussed their BCRA results with their physicians were more compliant with a six month breast exam with a doctor (53% vs 17%, p = 0.018). Overall, women felt that the BCRA was helpful and did not cause undue stress or anxiety. Although the cohort’s compliance with recommendations was suboptimal, physicians’ interactions with their patients may have a positive influence on their compliance.     

Measuring Hong Kong Undergraduate Students’ Attitudes Towards Transpeople

Hill and Willoughby’s (Sex Roles, 53:531–544, 2005) Genderism and Transphobia Scale (GTS), originally developed in Canada, was examined with a Hong Kong sample. Undergraduate students, 82 female and 121 male (total n?=?203), completed a Chinese version of the instrument. Overall scores and factor structure of the Hong Kong sample were compared with Hill and Willoughby’s Canadian data. Gender differences in transphobia were investigated, both in terms of the participants’ gender as well as the gender of the gender variant persons to whom GTS items referred. Transphobia was higher in Hong Kong than in Canada. The factor structure for Hong Kong differed from Canada. Five factors were identified (with a gender effect on Factors II and V). They were: I, Anti Sissy Prejudice; II, Anti Trans Violence; III, Trans Unnaturalness; IV, Trans Immorality; and V, Background Genderism. Hong Kong men were more transphobic than women. Gender variance in men was viewed less favourably than in women.     

How do Physicians Decide to Refer Their Patients for Psychiatric Genetic Counseling? A Qualitative Study of Physicians’ Practice

Psychiatric genetic counseling (PGC) is an emerging specialty discipline within the genetic counseling profession. A specialist PGC service was founded in 2012 in Vancouver, Canada, and though patient benefits have been demonstrated, many physicians do not regularly refer patients to the service despite awareness of its availability. We conducted a qualitative study involving semi-structured telephone interviews with Vancouver-based physicians who were aware of the PGC service to explore this phenomenon. Interviews were audio-recorded, transcribed verbatim, coded, and analysed for emergent themes. Consistent with a grounded theory approach, constant comparison was employed throughout data collection and analysis. Analyses of interviews conducted with 12 physicians revealed that referral practices were informed by perceptions about the purpose of PGC and interpretation of patient cues. Physicians perceived PGC as an information-focused intervention, and considered referral when patients explicitly expressed desire for information about recurrence risk or etiology that they felt unable to adequately address themselves. Even when physicians identified psychotherapeutic benefits of PGC, patient needs of this nature were not perceived as cues prompting referral to PGC. These data suggest that further work is necessary to position PGC in physicians’ minds as a service that could potentially benefit most individuals with psychiatric disorders and their families, and that it encompasses more than information provision. It is important to increase physicians’ awareness of the complementary role that genetic counselors can play to that of the physician in providing psychotherapeutically oriented counselling about illness etiology.     

逻辑训练对不同理性思维方式大学生三段论推理的影响

采用理性—经验思维方式量表对105名大学生进行测量,选出高、低理性思维方式各35名大学生进行实验,探讨了逻辑训练对不同理性思维方式大学生三段论推理的影响。结果表明：(1)高理性思维方式个体三段论推理的平均反应时快于低理性思维方式个体;非冲突类型题目推理的平均正确率高于冲突类型题目;逻辑训练可以提高个体三段论推理的平均反应时和正确率;(2)逻辑训练后非冲突任务类型题目的平均正确率高于冲突任务类型题目;(3)逻辑训练对低理性思维方式个体冲突任务类型题目平均正确率的提高效果更明显。这意味着逻辑训练可以显著提升个体的推理成绩,但不能完全消除信念偏差对推理的影响,而且逻辑训练对低理性思维方式个体推理成绩的提升效果更加明显。     

Enlivening thinking and speech in search of spiritual identity: the role of ‘speech formation’ in Steiner’s Waldorf education

ABSTRACT

The purpose of this paper is to clarify Steiner’s understanding of thinking and the way it influences the use of language in the classroom of 6–18 years old, and through that, to discuss how it eventually serves to capture one’s spiritual identity. First, the paper introduces Steiner’s notion of thinking, and then offers a general picture of what ‘speech formation’ is, and how it is actually used in a classroom. Secondly, the paper reviews Steiner’s view on child development and examines his understanding of embodied thinking in accordance with will, feeling and ‘I’ consciousness. Finally, it considers the role of ‘speech formation’ in relation to the development of thinking and speech, and to the genius of language which comes to work in the ‘space’ created through dialogue. (129 words)     

Individual Differences in Early Scientific Thinking: Assessment,Cognitive Influences,and Their Relevance for Science Learning

ABSTRACT

Early scientific thinking in kindergarten (6-year-olds) was investigated in a large study involving 227 participants. We investigated (1) whether individual differences across 3 scientific-thinking components (experimentation, data interpretation, and understanding the nature of science) are stable across children, (2) whether children’s increased information-processing skills (intelligence, language abilities) and their development of an advanced theory of mind (AToM) are potential mechanisms that bring about individual differences in scientific thinking, and (3) whether individual differences in scientific thinking predict individual differences in science content knowledge. Using a newly developed instrument with 30 items (the Science-K inventory), we found that a one-dimensional Rasch model provides a good fit to the data, showing that kindergarteners’ scientific thinking goes beyond competencies in single tasks. Individual differences across the diverse scientific-thinking tasks were stable, and children’s scientific thinking was correlated with their intelligence and their language abilities. AToM was an important precursor for scientific thinking, predicting it independently from the influences of information-processing skills. Children’s science content knowledge was predicted by their score on the Science-K inventory. This finding points to a specific relation between these 2 components of scientific literacy, and it supports the view that scientific-thinking skills help to better test and revise (wrong) beliefs and misconceptions about science. Our study is the first to reveal substantial individual differences in scientific thinking in children as young as kindergarteners, and it shows that scientific thinking is important for a successful learning of science concepts, even before children enter formal schooling and begin science education.     

Jung and Lévy-Bruhl

Abstract: For his knowledge of ‘primitive’ peoples, C. G. Jung relied on the work of Lucien Lévy‐Bruhl (1857–1939), a French philosopher who in mid‐career became an armchair anthropologist. In a series of books from 1910 on, Lévy‐Bruhl asserted that ‘primitive’ peoples had been misunderstood by modern Westerners. Rather than thinking like moderns, just less rigorously, ‘primitives’ harbour a mentality of their own. ‘Primitive’ thinking is both ‘mystical’ and ‘prelogical’. By ‘mystical’, Lévy‐Bruhl meant that ‘primitive’ peoples experience the world as identical with themselves. Their relationship to the world, including to fellow human beings, is that of participation mystique. By ‘prelogical’, Lévy‐Bruhl meant that ‘primitive’ thinking is indifferent to contradictions. ‘Primitive’ peoples deem all things identical with one another yet somehow still distinct. A human is at once a tree and still a human being. Jung accepted unquestioningly Lévy‐Bruhl's depiction of the ‘primitive’ mind, even when Jung, unlike Lévy‐Bruhl, journeyed to the field to see ‘primitive’ peoples firsthand. But Jung altered Lévy‐Bruhl's conception of ‘primitive’ mentality in three key ways. First, he psychologized it. Whereas for Lévy‐Bruhl ‘primitive’ thinking is to be explained sociologically, for Jung it is to be explained psychologically: ‘primitive’ peoples think as they do because they live in a state of unconsciousness. Second, Jung universalized ‘primitive’ mentality. Whereas for Lévy‐Bruhl ‘primitive’ thinking is ever more being replaced by modern thinking, for Jung ‘primitive’ thinking is the initial psychological state of all human beings. Third, Jung appreciated ‘primitive’ thinking. Whereas for Lévy‐Bruhl ‘primitive’ thinking is false, for Jung it is true—once it is recognized as an expression not of how the world but of how the unconscious works. I consider, along with the criticisms of Lévy‐Bruhl's conception of ‘primitive’ thinking by his fellow anthropologists and philosophers, whether Jung in fact grasped all that Lévy‐Bruhl meant by ‘primitive’ thinking.     

Democratic pluralism and majority rule

Abstract

I argue that Metz’s undertaking, in seeking a ‘comprehensive basic norm’ to underpin African ethics, is similar to Hans Kelsen’s postulation of the Grundnorm in his Pure Theory of Law. But African ethics does not need to be underpinned by an approach such as Kelsen’s. In my view, Metz’s preference for seeking to develop a Grundnorm rests upon a failure to attend carefully to the distinctness of African ethical thinking from Western ethical thinking. This failure is manifest in a spurious distinction (on which Metz relies) between ‘moral anthropology’ / ‘cultural studies’ and ‘normative theory’. It is also manifest in Metz’s failure to attend carefully to the work of Wiredu and Bujo, both of whom present systematic, critical analyses of African ethical thinking while implicitly rejecting the quest for a Grund norm as being unAfrican.     

Comparing the apple of my eye: Parental reactions to academic social comparisons of their elementary school-aged children

The current study examines parents’ reactions to making social comparisons of their children on school-related domains. Parents (N = 117; ages 25 to 49; 94% women) of elementary school-age children (ages 5 to 10; 57.3% girls) were recruited online from Facebook parenting groups and several school districts in Atlantic Canada. Participants were randomly assigned to make either an upward, a downward, or a lateral social comparison about their child’s ability in school. Participants reported the time since the event in comparison, their emotional reactions, their evaluations of their child’s ability in the domain, and how important they perceived the domain to be for their child’s future. Domain importance and evaluations of the child’s abilities also were measured prior to making the comparison. Significant differences based on social comparison condition were found for temporal distance, post-comparison domain importance, and post-comparison assessments of the child’s ability in the domain. The effect of social comparison on post-comparison domain importance was not mediated by post-comparison assessments of the child’s ability, suggesting a direct effect of comparisons on perceived domain importance. These findings suggest that the act of social comparison caused parents to reevaluate the importance of the domain of comparison and their child’s abilities in that domain. Implications for parents and educators are discussed.