Physicians' values and physician-value neutrality

For years articles have decried the lack of empathy in physicians' relationships with patients. In addition to being empathetic, physicians are called upon to assume the posture of value neutrality, i.e., not imposing one's values when dealing with patients. Empathy is clearly an expression of deeply held values; even the language used to define it is value-laden. Physicians are consistently called upon to exhibit traits which are expressions of their underlying values. However, if proponents of value-neutrality are to be taken literally one must not impose any of one's values on one's patients. But then one wonders how empathy could ever be expressed; further, it is hard to imagine what a truly value neutral physician would be like. It is time we recognize that any relationship between two persons requires the expression of values from both parties. These values help shape that relationship and define its further history. Physicians are not excluded from this process just because they consider themselves professionals. Divulging personal values to patients is both more honest and more in keeping with the concepts of justice, beneficence, non maleficence, and autonomy than to feign value-neutrality. A presentation of some type statement of values is timely and would give patients an idea of where a physician stands on a myriad of issues. Rather than being value-neutral, value non-neutrality seems a more right and reasonable posture for physicians to assume.     

The third person effect: Social distance and perceived media bias

Two studies were conducted to determine the conditions under which the third person effect (Davison, 1983) operates. It was hypothesized that the effect would be accentuated as target groups of others became more remote from the self. A second objective was to determine whether the effect operates in the absence of overtly persuasive intent in the media. Television programmes concerned with moral themes were employed as stimuli. The results further support Davison's claim that overestimation of media effects is greater when people imagine the responses of others whom they do not know than those of familar individuals. The results also indicate that the third person effect does operate in the absence of perceived persuasive intent, but is accentuated when bias is perceived by viewers.     

A behavioral assessment scale for attention deficit disorder in brazilian children based on DSM-IIIR criteria

A teacher scale based on DSM-III-R diagnostic criteria for attention deficit hyperactivity disorder (ADHD) was developed for the behavioral assessment of children in Brazil. A total of 2, 082 children (782 males and 1,300 females) with a mean age of 11.2 years who were attending a public school in the greater Rio de Janeiro area were the subjects of this study. Two factors (Hyperactivity-Impulsivity and Inattention) were extracted from a principal-factor analysis conducted on the data, and the factor structure of the scale was found to be stable. Ratings of boys were higher than ratings of girls, and younger children had higher ratings than older children for both factors. Test-retest reliability for each item of the scale ranged from .56 to .70. The data are discussed in view of current controversies in the factor structure of teacher ratings of DSM-III-R ADHD symptoms.This research was supported by FINEP (42.88.0138.00) and FUNPENE. GNOB is the recipient of a CNPq Research Career Development Award (30.0197/82). RCAP was supported by a CNPq fellowship (82.2151/87). The authors are grateful to Rosely V. Magalhaes and Angela S. Guedes for assistance in data analysis with the SAS and SPSS packages. The authors wish to thank the school staff and teachers who participated in the study. This work was presented at the Fifteenth European Conference of the International Neuropsychological Society, Portugal, 1993.     

Romantic partners and body image disturbance: Further evidence for the role of perceived—actual disparities

In this study, female and male college dyads (primarily Caucasian) involved in a “romantic relationship” used schematic figures to rate their conceptions of body size on a variety of rating protocols, including actual self, ideal self, ideal opposite gender, perceived partner's ideal opposite gender, perceived partner's rating of self, and rating of partner's body size. Based on the reflected-appraisal literature and previous body image research on perceived—actual disparities in body size ratings, five discrepancy indices were created and related to dispositional levels of body image disturbance, eating dysfunction, and general psychological function (self-esteem, depression). The results clearly indicated gender differences in the particular predictor associated with all measures of disturbance. For females, the discrepancy between the Self rating and the Perceived Partner's Ideal Other Gender rating accounted for almost all of the variance associated with clinical indices of disturbance. For males, the discrepancy between the Self rating and the Actual Partner's Ideal Other Gender rating was the only important predictor to emerge in regression analyses. The findings are interpreted in light of recent research on actual/perceived differences in body size ratings.     

School Counseling: An Evolving Specialty

This article provides a review of school counseling as a specialty area of the counseling profession, including attention to historical development, training standards and accreditation, certification, and future trends and issues.     

Frame multiplicity and policy fiascoes: Limits to explanation

The dynamics of intractability, frame multiplicity and intense controversy not only characterize policy formation struggles, as described by Schön and Rein, but also affect the evaluation of policies and government action. Policy analysts play an important part in the politics of policy evaluation. This article demonstrates that they tend to produce very different explanations for controversial, failing policies. Such differing explanations imply different causal attributions, different allocations of blame, and different lessons for future policy-making. Such differences are not random occurrences; they are embedded in the analytical frames that evaluators use to reconstruct policy processes and to explain their outcomes. It is shown that at least three deep-rooted frames can be reconstructed: fiascoes as failures of public problem solving, fiascoes as institutional imbalances, and fiascoes as system artefacts. One of the great epistemological challenges is how to deal with multiple analytical frames. The final part of the article discusses various strategies.     

An investigation of the relationship between self-efficacy and the communication effectiveness of product manual formats

Product manuals have been virtually ignored in published research despite their relevance to consumer satisfaction and marketplace safety. This study examines self-efficacy (perceptions of capabilities related to operating a product) and how it influences the effectiveness of and is also influenced by three safety message formats commonly used in product manuals (i.e., 1. safety messages presented in list format at the front of the manual; 2; safety messages presented by semantic similarity interspersed throughout the manual—chunked format, and 3. safety messages presented in a combined format—both list and chunked). As anticipated, pre-exposure self-efficacy was a significant covariate which was found to be positively related to post-exposure self-efficacy and negatively related to information evaluation. Further, controlling for pre-exposure self-efficacy, post-exposure self-efficacy was significantly lower in the combined (list plus chunked) condition. Findings of this research have important implications for the practice of repeating safety warnings and future research in the consumer information domain.Authors are listed in alphabetical order. This study was supported by an Illinois State University Research Grant.     

Wisdom and abiding interest: Interviews with three noted historians in later life

This article explores the connections between wisdom-related attributes and abiding interest and draws upon material from interviews with three eminent historians in later life. It is proposed that one characteristic of wisdom, namely, the coordination of affective/attaching and cognitive/detaching modes of processing information, is related to abiding interest or the ability to self-regulate attention in a way that promotes lifelong learning. The article (a) reviews pertinent constructs in the literatures on adult development and wisdom; (b) presents selected excerpts from in-depth interviews; and (c) concludes by discussing the developmental implications of the ideas presented.     

Parenting stress in parents of children with attention-deficit hyperactivity disorder and parents of children with learning disabilities

Parenting a child with ADHD can challenge parenting resources and coping. Increasingly, researchers are examining the relationship between the behavior of the child with ADHD and family functioning. While studies have shown inceased parenting stress in parents of children with ADHD, these studies have compared children with ADHD to non-disabled children. This study compares reports of parenting stress among mothers of children with ADHD, mothers of children with learning disabilities and mothers of non-referred children. Results showed that parenting stress was highest for mothers of children with ADHD. Increased parenting stress was associated with child characteristics and, in particular, with externalizing behavior problems.     

The ecumenical and non-ecumenical dialectic of Christian bioethics.

Non-ecumenical Christian bioethics will seem a strange category for many. The category relies on the recognition that bioethics mediates morality and ethics in healthcare. As such bioethics will have particular content. It is the content of a moral vision that both divides and unites. The enterprise of non-ecumenical Christian bioethics explores how Christians are both divided and united on the issue of bioethics. Non-ecumenical Christian bioethics is opposed to a facile ecumenism that reduces the content of Christian morality to the lowest common denominator.