Ethical issues in discharge planning for vulnerable infants and children

Discharge planning for vulnerable infants and children is a collaborative, interdisciplinary, decision-making activity that is grounded in the ethical complexities of clinical practice. Although it is a psychosocial intervention that frequently causes moral distress for professionals and has the potential to inflict harm on children and their families, the process has received little attention from ethicists. An ongoing study of the transition of technology-dependent children from hospital to home suggests that the ethical issues embedded in the discharge-planning process may be concealed by dominant cultural values, institutional policies, clinical standards, historical precedents, and legal regulations.     

Interbehavioral field systems assessment: Examining its utility in preservice teacher education

Behavior analytic evaluation instruments should benefit teacher education programs in assessing: (a) teacher and student interactions in practice teaching settings, and (b) the immediate and long range effects of the teacher training received. Though empirical substantiation remains scarce, such instruments may be designed to foster teacher trainee sensitivity to, and better control of, complex stimulus and response mechanisms which either impede or facilitate learning. This study analyzed one technologically driven Behavior Analysis Strategy and Taxonomy (BEST) and related Temporal Analysis System (TAS) (Hawkins, Sharpe, & Ray, 1994) currently used within one preservice teacher education program. A multiple probe design with experimental and control groups demonstrated the instruments' effects when used as an instructional feedback tool with teachers in training. Findings supported the instruments' use in terms of teacher and student behavior changes demonstrated for the experimental group as compared to a control group not exposed to the instrument. Implications of this technology when applied to teacher education are last described.     

On “knowing your partner”: Dangerous illusions in the age of AIDS?

We identified two characteristics of the impression formation process that may cause people to underestimate the riskiness of potential sexual partners. In Study 1, participants were quite confident that they could determine whether someone was lying to them about risk-related behavior when, in reality, they could not. Particularly troubling was a “truth bias” that resulted in relatively high rates of truth detection, but poor lie detection. In Study 2, increased familiarity with a target person (who actually was HIV+) caused participants to lower their estimates of the target's riskiness, despite the fact that we explicitly warned them that the target might be HIV+. We suggest that such processes may foster the illusion of knowing one's partner when one does not.     

Globalised Religion?: The ‘parliament of the world's religions’ (Chicago 1993) in theoretical perspective

This paper tests the hypothesis that contemporary global and globalised religion as exemplified in the Chicago ‘Parliament of the World's Religions’ of 1993 may be regarded as a resource which is central, rather than marginal to current human concerns in a threatened world. The paper is structured as follows. First, a short personal narrative gives some sense of what happened at the Parliament, and how this affected one of those present. Second, as a means of conveying the scale of the meeting, a brief content analysis and interpretation of the programme shows how (within certain limits) collaboration was made possible. Third, three insights are drawn from current sociology that facilitate an informed, albeit preliminary, evaluation of the Parliament as emancipatory event. These are: i) recent globalisation theory of the world system (Roland Robertson and Peter Beyer); ii) differentiation in a social reality understood as an “economy of signs and space”; (Scott Lash and John Urry); and in) the search for “meta‐theory”; in the “condition of post‐modernity”; (David Harvey). Fourth, some implications of the analysis and interpretation are drawn out which suggest that religion can be understood as a differentiated global resource, an ambiguous, yet dynamic form of ‘cultural capital’ of vital import in an era of post‐materialist value formation. Fifth, in conclusion, it is argued that thus understood the globalised religion represented by the 1993 ‘Parliament of the World's Religions’ has wider implications for the study of contemporary religion and forms of religiosity. Religion returns from the theoretical and cultural periphery (a marginalisation promoted by traditional secularisation theory) into a close relation to the core issues of our time. This is an optimistic interpretation of an event, the significance of which, in the opinion of this writer, should not be underestimated in the evaluation of religion as global resource.     

Extraction of relief from visual motion

We quantified the ability of human subjects to discriminate the relative distance of two points from a slanted plane when viewing the projected velocities of this scene (orthographic projection). The relative distance from a plane (called relief) is a 3-D property that is invariant under linear (affine) transformations. As such, relief canin principle be extracted from the instantaneous projected velocity field; a metric representation, which requires the extraction of visual acceleration, is not required. The stimulus consisted of a slanted planeP (specified by three points) and two pointsQ ₁ andQ ₂ that are non-coplanar withP. This configuration of points oscillated rigidly around the vertical axis. We have measured thesystematic error andaccuracy with which human subjects estimate the relative distance of pointsQ ₁ andQ ₂ from planeP as a function of the slant of_P. The systematic error varies with slant: it is low for small slant values, reaches a maximum for medium slant values, and drops again for high slant values. The accuracy covaries with the systematic error and is thus high for small and large slant values and low for medium slant values. These results are successfully modeled by a simple relief-from-motion computation based on local estimates of projected velocities. The data are well predicted by assuming (1) a measurement error in velocity estimation that varies proportionally to velocity (Weber’s law) and (2) an eccentricity-dependent underestimation of velocity.     

A behavioral link between the oculomotor and cardiovascular systems

Although the eyes and the heart serve very different purposes, each receives autonomic innervation. Capitalizing on recent theoretical and technological innovations in the understanding and assessment of oculomotor and cardiovascular behavior, three experiments measured behavioral covariation between the oculomotor and cardiovascular systems. Measures of dark focus and dark vergence indexed oculomotor tone, and the spectral decomposition of variations in heart rate indexed cardiovascular control mechanisms. In Experiment 1, individual differences in cardiovascular parameters could predict individuals’ dark vergence (R²=.806) but not their dark focus (R²=.404). In Experiment 2, the same parameters were measured from subjects who experience either panic attacks (n=11) or blood phobia (n=9). Heart rate was positively correlated with dark vergence and the two subject groups were separable based on both oculomotor and cardiovascular variables. Using a within-subjects approach, Experiment 3 found that both dark vergence and dark focus tended to be nearer during sympathetic dominance of the heart than during parasympathetic dominance, within-subjects variations in cardiovascular parameters could predict dark focus, and between-subjects variations in interbeat intervals could predict dark vergence. Shared patterns of autonomic activation may be responsible for this eye-heart link.     

Consciousness: A neurobiological approach

Consciousness and the disorders of consciousness can be more fully understood once they are integrated with the neurobiology of mental events. After a review of animal and human research, we found several anatomical structures in the central nervous system are required for consciousness. Identification of the critical structures, however, depends on what is meant by consciousness. In the general sense of mental responsivity, the reticular activating system must be intact. Consciousness has also been defined as the awareness of the sights, sounds, and feelings of everyday experience. In this sense, the system of sensory inputs and outputs of the anterior temporal cortex, amygdala, and the hippocampus must be functional. There is no neural evidence for “higher” consciousness.     

The assessment of cortisol using salivary ultrafiltrate

Cortisol can be used to indicate stress level as well as to monitor certain disease states. Although cortisol can be sampled from blood and urine, saliva sampling has decided advantages. Unfortunately, whole saliva contains a number of substances that can metabolize or bind with cortisol, potentially confounding analysis and quantitation. We introduce a semipermeable pouch that accumulates a contaminant-free salivary ultrafiltrate, thereby overcoming a number of the problems encountered with whole saliva. In three studies, we demonstrate accuracy and utility of the device for cortisol determination: (1) in an artificial medium, 60%–77% of the cortisol was recovered in the ultrafiltrate; (2) in vivo, ultrafiltrate cortisol correlated highly with whole-saliva cortisol collected under ideal conditions; and (3) ultrafiltrate cortisol evinced positive relationships with depression and cigarette use, consistent with studies in the literature. We conclude that this device and saliva-filtering technologies in general are useful in applications requiring quantitation of cortisol.