Spirituality in health-care reform

Much of the discussion about health-care reform has focused on questions of political and economic policies. By contrast, this article contends that this dispute involves deeper questions of meaning regarding the kinds of values, including spiritual values, that we wish to be present in health care. Communities of religious believers have a civic duty of responsibility and a theological duty of stewardship for health-care institutions. Such communities bring to the health-care debate spiritual meaning embedded in themes of humility, justice, and mercy. These virtues provide a moral test of the soundness of reform proposals.     

A skills training approach to the reduction of institutional offending

Offenses committed by those held in institutions can have repercussions at several levels: the individual must suffer the consequences of his or her actions; there may be a victim; and valuable staff time is spent adjudicating the outcome. A number of studies have suggested that an adjunct to behavioural training in institutions is a reduction in institutional misbehaviour—a suggestion which the present study sought to capitalize upon in a direct manner. In a borstal for young male law-breakers, referrals of individuals who received above average numbers of discipline reports in the institution were gathered. These people were then offered a place on a training course designed to attempt to modify behaviour towards authority figures, prison officers in particular. The course was carried out in two forms: a ‘Short’ Course of 4 days duration, and a ‘Long” Course spread over 8 weeks. Assessment of the effects of training was made by monitoring levels of discipline reports, and also by the administration of self-report and personality scales. Compared with No-training and Non-referred Controls, no significant changes in the frequency of receiving discipline reports was found following either mode of training. However, a number of changes on the self-report and personality measures suggested some degree of change after training. Implications for the construction of future courses with similar objectives are discussed.     

DECIDING WHOM TO TELL: EXPECTATIONS AND OUTCOMES OF RAPE SURVIVORS' FIRST DISCLOSURES

In this study, 102 female rape survivors were interviewed regarding their first post-assault disclosure. Qualitative analysis revealed that nearly 75% of first disclosures were to informal support providers and over one third of the disclosures were not initiated by the survivors themselves. Over half of the survivors received positive reactions and less than one third felt the disclosure had a detrimental impact on their recovery. Loglinear analysis suggested that survivors who actively sought help from informal support providers were more likely to receive positive than negative reactions. In contrast, survivors who actively sought help from formal support providers were more likely to receive negative than positive reactions. When disclosure to formal support providers was initiated by the formal support providers themselves, however, survivors received exclusively positive reactions. Implications for future research are discussed.     

Using activity schedules to promote varied application use in children with autism

We evaluated the effects of an activity schedule embedded within an iPad on varied play across applications. After establishing a pattern of repetitive gameplay, we taught three children with autism to follow the activity schedule using physical guidance. All participants increased their varied play to four applications per session and demonstrated independent and accurate activity schedule usage. The activity schedule was removed, and responding decreased to baseline levels, demonstrating the activity schedule's control over varied responding. The activity schedule was reintroduced and participant responding maintained when engaging with novel applications.     

The impact of aerobic activity on cognitive function in older adults: A new synthesis based on the concept of executive control

Numerous reaction time studies have suggested that age-related declines in cognitive function might be ameliorated by lifestyles involving aerobic activity or by interventionist programmes of aerobic exercise. These studies are far from conclusive, however, reflecting a failure to factor out cognitive from sensory and motor processes. Following a critical review of the literature, we report on recent developments that differentiate cognitive processes involving executive vs non-executive control, the former being associated with frontal lobe function. Three key studies suggest that aerobic exercise primarily improves executive control.     

A methodology for assessing the functions of emerging speech in children with developmental disabilities

An approach based on Skinner's (1957) theory of verbal behavior has been developed to understand and teach elementary communication skills to children with autism and developmental disabilities (Sundberg & Partington, 1998). However, few studies have directly examined the characteristics of emerging language in children with developmental disabilities. The purpose of this study was to develop and evaluate an assessment for identifying the elementary functions of vocal speech in children. Participants were 4 children with developmental disabilities, aged 6 years to 12 years, who exhibited at least one distinguishable vocal response (word or phrase) frequently in the natural environment. The assessment focused on three verbal operants delineated by Skinner (mand, tact, and intraverbal). One or more functions were identified for at least one vocal response of each child. Results suggested that this assessment would be useful for (a) evaluating Skinner's theory, (b) guiding decisions about language training for individual children, and (c) studying the nature of expressive language development in children with developmental disabilities.     

Reliability and validity of the Beck depression inventory--II with adolescent psychiatric inpatients

This investigation was conducted to validate the Beck Depression Inventory--II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) in samples of adolescent psychiatric inpatients. The sample in each substudy was primarily Caucasian. In Study 1, expert raters (N=7) and adolescent psychiatric inpatients (N=13) evaluated the BDI-II items to assess content validity. In Study 2, confirmatory factor analyses of several first-order solutions failed to provide adequate fit estimates to data for 205 boys, 203 girls, and the combined sample. Exploratory factor analyses identified new item-factor solutions. Reliability estimates were good (range =.72 to.91) for the BDI-II total and scale scores. In Study 3 (N=161 boys and 158 girls from Study 2), preliminary evidence for estimates of concurrent, convergent, and discriminant validity were established for the BDI-II.