Effects of Alternative Outcome Scenarios and Structured Outcome Evaluation on Case-Based Ethics Instruction

Case-based instruction has been regarded by many as a viable alternative to traditional lecture-based education and training. However, little is known about how case-based training techniques impact training effectiveness. This study examined the effects of two such techniques: (a) presentation of alternative outcome scenarios to a case, and (b) conducting a structured outcome evaluation. Consistent with the hypotheses, results indicate that presentation of alternative outcome scenarios reduced knowledge acquisition, reduced sensemaking and ethical decision-making strategy use, and reduced decision ethicality. Conducting a structured outcome evaluation had no impact on these outcomes. Results indicate that those who use case-based instruction should take care to use clear, less complex cases with only a singular outcome if they are seeking these types of outcomes.     

Rival reading: Deleuze on Hume

Book Information Environmental Philosophy and Ethics in Buddhism. Environmental Philosophy and Ethics in Buddhism Padmasiri de Silva London Macmillan Press 1998 xviii + 195 Hardback AUS$69.95 By Padmasiri de Silva. Macmillan Press. London. Pp. xviii + 195. Hardback:AUS$69.95,     

Reliable Ratings or Reading Tea Leaves: Can Parent,Teacher, and Clinician Behavioral Ratings of Preschoolers Predict ADHD at Age Six?

To assess the relative ability of parent, teacher, and clinician behavioral ratings of preschoolers to predict ADHD severity and diagnosis at 6 years of age. Hyperactive/inattentive preschoolers [N?=?104, 75 % boys, Mean (SD) age?=?4.37 (0.47) years] were followed over 2 years (mean?=?26.44 months, SD?=?5.66). At baseline (BL), parents and teachers completed the ADHD-RS-IV and clinicians completed the Behavioral Rating Inventory for Children following a psychological testing session. At age 6, [Mean (SD) age?=?6.62 (0.35) years], parents were interviewed with the K-SADS-PL; teachers completed the ADHD-RS-IV; and laboratory measures of hyperactivity, impulsivity, and inattention were obtained from children. Hierarchical logistic and linear regression analyses examined which combination of BL ratings best predicted 6-year-old ADHD diagnosis and severity, respectively. At age 6, 56 (53.8 %) children met DSM-IV criteria for a diagnosis of ADHD. BL ratings from parent/teacher/clinician, parent/teacher and parent/clinician combinations significantly predicted children who had an ADHD diagnosis at age 6. Parent and clinician, but not teacher, behavior ratings were significant independent predictors of ADHD diagnosis and severity at 6-years-old. However, only clinician reports of preschoolers’ behaviors predicted laboratory measures of over-activity and inattention at follow-up. Cross-situationality is important for a diagnosis of ADHD during the preschool years. Among parents, teachers and clinicians, positive endorsements from all three informants, parent/teacher or parent/clinician appear to have prognostic value. Clinicians’ ratings of preschoolers’ inattention, impulsivity and hyperactivity are valid sources of information for predicting ADHD diagnosis and severity over time.     

Assessing the Integrity of Clinical Data: When is Statistical Evidence Too Good to be True?

Evidence, as viewed through the lens of statistical significance, is not always as it appears! In the investigation of clinical research findings arising from statistical analyses, a fundamental initial step for the emerging fraud detective is to retrieve the source data for cross-examination with the study data. Recognizing that source data are not always forthcoming and that, realistically speaking, the investigator may be uninitiated in fraud detection and investigation, this paper will highlight some key methodological procedures for providing a sounder evidence base for withdrawing from a study on grounds of integrity. The promotion of patient safety is paramount. However, there is a broader rationale for disseminating these ideas. This includes empowering researchers to optimize their personal integrity, make informed choices regarding membership of future research collaborations and successfully voice their concerns to journal editors, particularly where a conflict of interests can render such dialogues particularly difficult. Recommendations will be supported by topical case studies and practical steps involving data exploration, testing of baseline data and application of Benford’s Law. While this paper has a clinical focus, the advice provided is transferrable to a wide range of multidisciplinary research settings outside of Medicine.     

Tier 2 Reading Fluency Interventions With Middle School Students: A Comparison of the HELPS-SG Program and a Teacher-Directed Evidence-Based Intervention

This randomized study evaluated two evidence-based reading interventions with 121 middle school students who presented with reading fluency deficits. One intervention was teacher-directed and utilized numerous evidence-based strategies; the other intervention, the Helping Early Literacy with Practice Strategies for Small Groups Program, provided a structured implementation protocol of evidence-based strategies and specific intervention materials. Students in both groups demonstrated statistically significant growth on standardized measures of reading fluency and comprehension, but there were no differences between intervention conditions for any of the dependent measures. Practical implications for using oral reading fluency interventions at the middle school level are discussed.     

Sensitivity of the Wisconsin Card Sorting Test (64-Card Version) versus the Tower of London (Drexel Version) for detecting executive dysfunction in children with epilepsy

Executive function deficits are common in children and adolescents with epilepsy. Though the Wisconsin Card Sorting Task (WCST) is often considered the “gold standard” for executive function assessment, its sensitivity—particularly in the case of the 64-card version (WCST-64)—is insufficiently established in pediatric samples, including children and adolescents with epilepsy. The present investigation assesses the sensitivity of the WCST-64 in children and adolescents with epilepsy in comparison to another measure: the Tower of London – Drexel Version (TOL-DX). A total of 88 consecutively referred children and adolescents with epilepsy were administered both the WCST-64 and TOL-DX as part of a comprehensive neuropsychological evaluation. The sensitivity of WCST-64 and TOL-DX variables were established and relations with epilepsy severity measures and other executive function measures were assessed. Of the WCST-64 variables, Perseverative Responses is the most sensitive, but detected executive function impairment in only 19% of this clinically referred sample; in contrast, the TOL-DX Rule Violations detected executive function impairment in half of the sample. Further, TOL-DX performances are more strongly related to epilepsy severity variables and other executive function measures in comparison to the WCST-64. Despite its popularity amongst clinicians, the WCST-64 is not as sensitive to executive dysfunction in comparison to other measures of comparable administration time, such as the TOL-DX.     

Introductory Comments

Three groups of informants—two in California, one in Atlanta—recalled their experiences of the 1989 Loma Prieta earthquake shortly after the event and again 1 1/2 years later. The Californians' recalls of their own earthquake experiences were virtually perfect. Even their recalls of hearing the news of an earthquake-related event were very good: much higher than Atlantan recalls of hearing about the quake itself. Atlantans who had relatives in the affected area remembered significantly more than those who did not. These data show that personal involvement in the quake led to greatly improved recall, but do not show why. Many Californian informants reported low levels of stress/arousal during the event; arousal ratings were not significantly correlated with recall. The authors suggest that repeated narrative rehearsals may have played an important role.     

Children's narratives and well-being

Research with adults indicates that writing causal-explanatory and emotionally disclosing narratives of stressful experiences is related to psychological well-being. Limited research with children has shown mixed results, but developmental theory suggests that simple extrapolation from adult findings might be problematic. In this study, 9- to 13-year-old children engaged in three days of writing under emotional and non-emotional instructions, and completed measures of depression, anxiety, strengths and difficulties, and somatic symptoms both at baseline and 2 months following intervention. Narratives were coded using a developmentally appropriate, exhaustive coding system. Children in the emotional writing group wrote more about negative evaluations, problems, emotions, explanations and coping than children in the non-emotional writing group. However, those children who wrote more about negative evaluations, problems and explanations subsequently showed higher levels of anxiety, depression and difficulties. Due to limited narrative and emotional regulation skills, expressive writing may not benefit, and may even be detrimental for, some children.     

Sexual orientation and shifts in preferences for a partner's body attributes in short-term versus long-term mating contexts

This study assessed the effects of short- and long-term mating contexts on preferences for body characteristics of potential relationship partners in lesbians and heterosexual women. Lesbians (n = 41) rated figure drawings and computer-generated images of women that varied in body fat, waist-to-hip ratio, and breast size; heterosexual women (n = 95) rated computer-generated images of men that varied in muscularity and body fat. Both lesbians and heterosexual women showed a shift in preferences toward more physically attractive partners for shortterm relationships. All body aspects were affected, except that heterosexual women did not show a preference shift for male body fat. The results were interpreted in terms of a mating trade-off strategy in which mate preferences are the consequence of cost/benefit analyses and suggest that preferences for physical attributes of sexual partners may be shared by members of the same sex regardless of sexual orientation.