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991.
Ryan?M?AntielEmail author Farr?A?Curlin Katherine?M?James Jon?C?Tilburt 《Philosophy, ethics, and humanities in medicine : PEHM》2013,8(1):13
Introduction
Physicians vary in their moral judgments about health care costs. Social intuitionism posits that moral judgments arise from gut instincts, called “moral foundations.” The objective of this study was to determine if “harm” and “fairness” intuitions can explain physicians’ judgments about cost-containment in U.S. health care and using cost-effectiveness data in practice, as well as the relative importance of those intuitions compared to “purity”, “authority” and “ingroup” in cost-related judgments.Methods
We mailed an 8-page survey to a random sample of 2000 practicing U.S. physicians. The survey included the MFQ30 and items assessing agreement/disagreement with cost-containment and degree of objection to using cost-effectiveness data to guide care. We used t-tests for pairwise subscale mean comparisons and logistic regression to assess associations with agreement with cost-containment and objection to using cost-effectiveness analysis to guide care.Results
1032 of 1895 physicians (54%) responded. Most (67%) supported cost-containment, while 54% expressed a strong or moderate objection to the use of cost-effectiveness data in clinical decisions. Physicians who strongly objected to the use of cost-effectiveness data had similar scores in all five of the foundations (all p-values?>?0.05). Agreement with cost-containment was associated with higher mean “harm” (3.6) and “fairness” (3.5) intuitions compared to “in-group” (2.8), “authority” (3.0), and “purity” (2.4) (p?<?0.05). In multivariate models adjusted for age, sex, region, and specialty, both “harm” and “fairness” were significantly associated with judgments about cost-containment (OR?=?1.2 [1.0-1.5]; OR?=?1.7 [1.4-2.1], respectively) but were not associated with degree of objection to cost-effectiveness (OR?=?1.2 [1.0-1.4]; OR?=?0.9 [0.7-1.0]).Conclusions
Moral intuitions shed light on variation in physician judgments about cost issues in health care.992.
Shaun?Stevenson B?Lynn?Beattie Richard?Vedan Emily?Dwosh Lindsey?Bruce Judy?IllesEmail author 《Philosophy, ethics, and humanities in medicine : PEHM》2013,8(1):15
The meaningful consideration of cultural practices, values and beliefs is a necessary component in the effective translation of advancements in neuroscience to clinical practice and public discourse. Society’s immense investment in biomedical science and technology, in conjunction with an increasingly diverse socio-cultural landscape, necessitates the study of how potential discoveries in neurodegenerative diseases such as Alzheimer disease are perceived and utilized across cultures. Building on the work of neuroscientists, ethicists and philosophers, we argue that the growing field of neuroethics provides a pragmatic and constructive pathway to guide advancements in neuroscience in a manner that is culturally nuanced and relevant. Here we review a case study of one issue in culturally oriented neuroscience research where it is evident that traditional research ethics must be broadened and the values and needs of diverse populations considered for meaningful and relevant research practices. A global approach to neuroethics has the potential to furnish critical engagement with cultural considerations of advancements in neuroscience. 相似文献
993.
Bruno?FalissardEmail author Anne?Révah Suzanne?Yang Anne?Fagot-Largeault 《Philosophy, ethics, and humanities in medicine : PEHM》2013,8(1):18
In recent decades, there has been widespread debate in the human and social sciences regarding the compatibility and the relative merits of quantitative and qualitative approaches in research. In psychiatry, depending on disciplines and traditions, objects of study can be represented either in words or using two types of mathematization. In the latter case, the use of mathematics in psychiatry is most often only local, as opposed to global as in the case of classical mechanics. Relationships between these objects of study can in turn be explored in three different ways: 1/ by a hermeneutic process, 2/ using statistics, the most frequent method in psychiatric research today, 3/ using equations, i.e. using mathematical relationships that are formal and deterministic. The 3 ways of representing entities (with language, locally with mathematics or globally with mathematics) and the 3 ways of expressing the relationships between entities (using hermeneutics, statistics or equations) can be combined in a cross-tabulation, and nearly all nine combinations can be described using examples. A typology of this nature may be useful in assessing which epistemological perspectives are currently dominant in a constantly evolving field such as psychiatry, and which other perspectives still need to be developed. It also contributes to undermining the overly simplistic and counterproductive beliefs that accompany the assumption of a Manichean “quantitative/qualitative” dichotomy. Systematic examination of this set of typologies could be useful in indicating new directions for future research beyond the quantitative/qualitative divide. 相似文献
994.
Jimmeka J. Guillory Lisa Geraci 《Journal of applied research in memory and cognition》2013,2(4):201-209
People often continue to rely on erroneous information about people and events, even in the face of subsequent counter information. The current study examined whether this information could be effectively corrected by a credible source. We examined two aspects of credibility: trustworthiness and expertise. Experiment 1 showed that receiving a correction from a source high in trustworthiness and expertise reduced participants’ use of original information when making inferences. Experiment 2 showed that source expertise alone was not sufficient to reduce participants’ reliance on the original information. The results from Experiment 3 showed that source trustworthiness alone significantly decreased participants’ use of the original information when making inferences. The results suggest that people may be able to reduce their use of original information if they receive a correction from a person who is deemed to be highly trustworthy. These findings have implications for decision making in politics and other applied areas. 相似文献
995.
Core systems of number 总被引:31,自引:0,他引:31
What representations underlie the ability to think and reason about number? Whereas certain numerical concepts, such as the real numbers, are only ever represented by a subset of human adults, other numerical abilities are widespread and can be observed in adults, infants and other animal species. We review recent behavioral and neuropsychological evidence that these ontogenetically and phylogenetically shared abilities rest on two core systems for representing number. Performance signatures common across development and across species implicate one system for representing large, approximate numerical magnitudes, and a second system for the precise representation of small numbers of individual objects. These systems account for our basic numerical intuitions, and serve as the foundation for the more sophisticated numerical concepts that are uniquely human. 相似文献
996.
H F?rstl 《Brain and language》1991,40(1):145-150
John Abercrombie (1780-1844) was considered the most eminent Scottish physician of his time. In his Pathological and Practical Researches on the Diseases of the Brain and Spinal Cord (1836, Edinburgh: John Carfrae and Son, 3rd ed.) he described the cases of 140 patients with cerebral disorders, 48 of whom suffered from language disturbances. Despite the overwhelming clinical and neuropathological evidence of a close association between language disorder and right-sided hemiparesis or diseases of the left hemisphere, and in spite of his great interest in language disorders, he made no attempt to localize the aphasic syndrome to a specific brain area. 相似文献
997.
998.
Epstein Michael L. Lazarus Amber D. Calvano Tammy B. Matthews Kelly A. Hendel Rachel A. Epstein Beth B. Brosvic Gary M. 《The Psychological record》2002,52(2):187-201
The Psychological Record - Multiple-choice testing procedures that do not provide corrective feedback facilitate neither learning nor retention. In Studies 1 and 2, the performance of participants... 相似文献
999.
Terry E. Duncan Susan C. Duncan Lisa A. Strycker Fuzhong Li 《Journal of psychopathology and behavioral assessment》2002,24(1):1-12
This paper presents a latent growth SEM approach for the estimation of treatment effects, and power to detect such effects, within a true experimental design setting in which subjects are randomly assigned to treatment and control conditions. Power estimation is a critical component of intervention experiment design and the testing of their results. Although researchers have become increasingly sophisticated in applying tests for statistical significance in intervention contexts, few are aware of the power of these tests. The issues raised in this paper are not new; however, reminding researchers to consider these points is important. Exactly how the researcher handles these issues will depend on the questions asked and the resources available, as well as other considerations. Discussion underscores the relationship between the reliability of a study's measures and concomitant increases in power obtained within the SEM framework. 相似文献
1000.
Parent-Adolescent Relationship and Adolescent Psychological Functioning among African-American Female Adolescents: Self-Esteem as a Mediator 总被引:1,自引:0,他引:1
African-American female adolescents living in urban areas are at increased risk for adverse adjustment outcomes. The present study accomplished two goals. First, the quality of the parent-adolescent relationship across age groups was examined for differences among younger (i.e., 12'14) versus mid-range (i.e., 15'16) versus older (i.e., 17'18) adolescents. Second, self-esteem was examined as a possible mediator of the relationship between the quality of the parent-adolescent relationship and adolescent psychological functioning in a sample of 608 African-American urban adolescent females. With regard to developmental shifts in the quality of the parent-adolescent relationship, midrange adolescents reported a significantly poorer relationship with their mother than older adolescents. Results also indicated that self-esteem partially mediated the relationship between parent-child relationship and adolescent psychological functioning. Mental health professionals can broaden their interventions that aim to improve adolescent psychological functioning by either focusing on the quality of the parent-adolescent relationship or adolescent self-esteem. 相似文献