Discrete varieties of care in the clinical pastoral tradition: continuing the dialogue

In the current cultural context, clinically trained ministers, lay and ordained, offer themselves to troubled souls through at least three distinct varieties of assistance: pastoral care, pastoral counseling, and pastoral psychotherapy. This essay delineates three accepted disciplines, emphasizing the importance of ascertaining, and perhaps re-evaluating, the particular needs and desires of persons who are in physical, mental, or spiritual distress. "Pastoral care," "pastoral counseling," and "pastoral psychotherapy" each play an important role in fulfilling the traditional mandate for "the cure of souls."     

The Use of a Family History Risk Assessment Tool within a Community Health Care System: Views of Primary Care Providers

Primary care providers (PCPs) offered input regarding the incorporation of a family health history (FHH) risk assessment tool into a community health care system (CHCS). Sixteen PCPs participated in one of three focus groups. Perceived impediments included the lack of standard screening guidelines, effective screening tests, genetic counseling resources, and services for high-risk patients. The PCPs were concerned about their level of expertise, the cost of preventive health care, and genetic discrimination. They also were concerned about the use of a FHH tool by oncologists within the CHCS because of communication gaps between oncologists and PCPs, lack of clarity regarding follow-up and legal liability, and reimbursement issues. To integrate a FHH tool into a CHCS, PCPs will need consultation and referral services, evidence-based recommendations, and "just-in-time" educational resources. Oncologists who use the tool will need to develop a streamlined communication system with PCPs, establish clearly defined roles, and ensure patient follow-up.     

Propositions and same-saying: introduction

Philosophers often talk about the things we say, or believe, or think, or mean. The things are often called ??propositions??. A proposition is what one believes, or thinks, or means when one believes, thinks, or means something. Talk about propositions is ubiquitous when philosophers turn their gaze to language, meaning and thought. But what are propositions? Is there a single class of things that serve as the objects of belief, the bearers of truth, and the meanings of utterances? How do our utterances express propositions? Under what conditions do two speakers say the same thing, and what (if anything) does this tell us about the nature of propositions? There is no consensus on these questions??or even on whether propositions should be treated as things at all. During the second Propositions and Same-Saying workshop, which took place on July 19?C21 2010?at the University of Sydney, philosophers debated these (and related) questions. The workshop covered topics in the philosophy of language, perception, and metaphysics. The present volume contains revised and expanded versions of the papers presented at the workshop.     

Movement control in older adults: does old age mean middle of the road?

Old age is associated with poorer movement skill, as indexed by reduced speed and accuracy. Nevertheless, reductions in speed and accuracy can also reflect compensation as well as deficit. We used a manual tracing and a driving task to identify generalized spatial and temporal compensations and deficits associated with old age. In Experiment 1, participants used a hand-held stylus to trace a path. In Experiment 2, participants steered along paths in a virtual reality driving simulator. In both experiments, participants were required to stay within the boundaries while we manipulated task difficulty by changing path width or movement speed. The older group showed worse performance in the highly constrained conditions. Corner cutting effectively reduces the curvature of bends but yields a greater risk of error (i.e., clipping the path or road edge). Corner cutting is thus less risky on wider paths, and we found that corner cutting increased for both age groups in both tasks when paths were wider. Crucially, we observed a greater degree of corner cutting in the young group compared with the old, suggesting the old group compensated for decreased motor skill with "middle-of-the-road" behavior. Enforcing increased speed caused all participants to increase corner cutting. Thus, older participants showed spatial compensation for decreased skill by biasing their position toward the middle of the path in both a manual and steering task. External constraints (narrow paths and fast speeds) prevented this strategy and revealed age-related declines in skills central to manual control and driving.     

Additive effects of social and non‐social attention during infancy relate to later autism spectrum disorder

Emerging findings from studies with infants at familial high risk for autism spectrum disorder (ASD), owing to an older sibling with a diagnosis, suggest that those who go on to develop ASD show early impairments in the processing of stimuli with both social and non‐social content. Although ASD is defined by social‐communication impairments and restricted and repetitive behaviours, the majority of cognitive theories of ASD posit a single underlying factor, which over development has secondary effects across domains. This is the first high‐risk study to statistically differentiate theoretical models of the development of ASD in high‐risk siblings using multiple risk factors. We examined the prediction of ASD outcome by attention to social and non‐social stimuli: gaze following and attentional disengagement assessed at 13 months in low‐risk controls and high‐risk ASD infants (who were subsequently diagnosed with ASD at 3 years). When included in the same regression model, these 13‐month measures independently predicted ASD outcome at 3 years of age. The data were best described by an additive model, suggesting that non‐social attention, disengagement, and social attention as evidenced by gaze following, have a cumulative impact on ASD risk. These data argue against cognitive theories of ASD which propose that a single underlying factor has cascading effects across early development leading to an ASD outcome, and support multiple impairment models of ASD that are more consistent with recent genetic and neurobiological evidence.     

Learning and consolidation of new spoken words in autism spectrum disorder

Autism spectrum disorder (ASD) is characterized by rich heterogeneity in vocabulary knowledge and word knowledge that is not well accounted for by current cognitive theories. This study examines whether individual differences in vocabulary knowledge in ASD might be partly explained by a difficulty with consolidating newly learned spoken words and/or integrating them with existing knowledge. Nineteen boys with ASD and 19 typically developing (TD) boys matched on age and vocabulary knowledge showed similar improvements in recognition and recall of novel words (e.g. ‘biscal’) 24 hours after training, suggesting an intact ability to consolidate explicit knowledge of new spoken word forms. TD children showed competition effects for existing neighbors (e.g. ‘biscuit’) after 24 hours, suggesting that the new words had been integrated with existing knowledge over time. In contrast, children with ASD showed immediate competition effects that were not significant after 24 hours, suggesting a qualitative difference in the time course of lexical integration. These results are considered from the perspective of the dual‐memory systems framework.     

Prosecutors' Perspectives on Clarifying Terms for Genitalia in Child Sexual Abuse Interviews

In investigative interviews with alleged victims of child sexual abuse, professionals must establish the nature of the alleged abuse by determining what body parts were involved in the offending. This can be difficult, however, because children often use colloquial (non‐anatomical) terms to describe genitalia, and there has been little direction for interviewers about clarifying these terms sufficiently to establish the charge. The aim of this study was to address the need for guidance from prosecutors about the level of clarity in terms required from a legal perspective, and how this clarity can be achieved. A focus group of nine prosecutors (representing all but one Australian State and Territory) were asked to consider what degree of clarity in terminology for genitalia was adequate and how such clarity could be achieved. Thematic analysis revealed that a reduction in specific questioning around genitalia would improve the usefulness of investigative interviews with children from a legal perspective. Recommendations for improving interviews about abuse with child witnesses are discussed.     

The Impact of Feminist Attitudes on the Relation between Racial Awareness and Racial Identity

This study examined the role of liberal and inclusive feminist attitudes in the development of a positive racial identity in a sample of White female undergraduates in the Midwestern United States. Participants (N?=?90) provided self-report data on their racial awareness, liberal and inclusive feminist attitudes, racial identity and demographic information. The main research question was how and to what extent liberal and inclusive feminism influence the relationship between racial awareness and racial identity. Building on conceptual scholarship on identity theory and the intersectionality, results indicated that the relation between racial awareness and racial identity was partially mediated by inclusive feminist attitudes but not by liberal feminist attitudes. The results suggest that a specific type of feminism, which takes into account the experience of race, plays a significant role in our understanding of how White women develop a positive White identity. Results highlight the intersection of race and gender in college student development and have potential implications for administrative responses to student adjustment in increasingly diverse college environments.