Toward an expanded vision of clinical ethics education: from the individual to the institution

This paper advances a new paradigm in clinical ethics education that not only emphasizes development of individual clinicians' skills, but also focuses on the institutional context within which health care professionals work. This approach has been applied to the goal of improving the care provided to critically and terminally ill adults. The model has been adopted by about thirty hospitals and nursing homes; additional institutions will soon join the program, entitled Decisions Near the End of Life. Here, we describe the history and rationale for this approach, its goals, pedagogical assumptions, and design.     

A microprocessor control system and solid state interface for controlling electrophysiological studies of conditioning

This paper describes a microprocessor control system and solid state interface for controlling the apparatus in combined behavioral-electrophysiological studies of conditioning. The computer program, which is designed to control classical conditioning of the rabbit’s nictitating membrane response, provides the flexibility to control all conditioning parameters (e.g., interstimulus and intertrial intervals, trial type, and sequence of trial types) with only minor modifications. The system is free from artifacts that can distort electrophysiological recordings and can easily be modified to accommodate other behavioral paradigms in which electrophysiological responses are recorded.     

Rational emotive behavior therapy research: What we know and what we need to know

Rational emotive behavior therapy (REBT) has achieved positive results in quantitative reviews of treatment outcome studies. In part because of methodological limitations of these studies, however, the generalizability of their favorable results to routine clinical practice is unknown. Also unknown are the clinical significance of outcomes achieved by REBT, the contribution made by its distinctive and specialized procedures, and the types of patients for whom REBT is particularly useful. Recommendations are provided for refining our knowledge of the effectiveness of REBT.     

Coping with war captivity: The role of sensation seeking

This study examines the implication of both sensation seeking and the subjective appraisal of captivity in the long-term adjustment of ex-prisoners of war (ex-POWs). 164 Israeli ex-POWs and 184 comparable controls were studied, 18 years after their participation in the Yom Kippur War. The findings indicate that high-sensation seekers adjusted better than low-sensation seekers to the stresses of captivity. Low-sensation-seeking ex-POWs reported more PTSD symptoms, more severe psychiatric symptomatology, and more intense intrusive and avoidance tendencies. High- and low-sensation-seeking POWs differed also in feelings when taken prisoner, subjective assessment of suffering in prison, ways of coping with prison, and emotional states during captivity. The present study supports the postulation that sensation seeking is an important stress-buffering personal resource. The role of coping styles in long-term adjustment following war captivity is discussed.     

Two models of group behavior in the solution of eureka-type problems

A study by Shaw (7) some twenty years ago is frequently cited by social scientists to support the generalization that groups are superior to individuals in problem-solving. Shaw suggests that personal interaction within the group is responsible for the superior performance of groups. This article re-examines her data in the light of two models which propose that the difference in quality of solution between group and individual performance is solely a matter of ability. It is shown that Shaw's data may be considered to have been an outcome of behavior postulated by the models. Since Shaw's observations relate to a special population and to special kinds of problems, the proposed models may not be appropriate under differing experimental conditions. In fact, Lorgeet al. (4) have indicated that experimental demonstration of the superiority of groups over individuals in problem-solving depends not only on the kind of group but also on the kind of problem to be solved. In addition, the diversity of transfer of training for groups and for individuals is considered.Supported in part by the Office of Naval Research under Contract N6 onr 266 (21) and the Air Force Personnel and Training Research Center under Contract AF 18(600)-341.     

Does Reductive Proof Theory Have A Viable Rationale?

The goals of reduction andreductionism in the natural sciences are mainly explanatoryin character, while those inmathematics are primarily foundational.In contrast to global reductionistprograms which aim to reduce all ofmathematics to one supposedly ``universal' system or foundational scheme, reductive proof theory pursues local reductions of one formal system to another which is more justified in some sense. In this direction, two specific rationales have been proposed as aims for reductive proof theory, the constructive consistency-proof rationale and the foundational reduction rationale. However, recent advances in proof theory force one to consider the viability of these rationales. Despite the genuine problems of foundational significance raised by that work, the paper concludes with a defense of reductive proof theory at a minimum as one of the principal means to lay out what rests on what in mathematics. In an extensive appendix to the paper,various reduction relations betweensystems are explained and compared, and arguments against proof-theoretic reduction as a ``good' reducibilityrelation are taken up and rebutted.     

The Daily Spiritual Experiences Scale and Well-Being: Demographic Comparisons and Scale Validation with Older Jewish Adults and a Diverse Internet Sample

A substantive literature connects spirituality to positive physical, social, and mental health. In this study, the Daily Spiritual Experiences Scale (DSES) was administered to 410 subjects who participated in a community study and to 87 residents at the Hebrew Home for the Aged at Riverdale (HHAR), the latter sample consisting primarily of older Jewish respondents. Internal consistency of the DSES in both samples was high and exploratory factor analyses revealed one dominant factor and a second factor, which included 14 and 2 items, respectively, consistent with the scale’s original validation (Underwood and Teresi 2002). Demographic subgroup comparison among religious groups revealed significantly fewer daily spiritual experiences among Jews, and lowest scores among those respondents endorsing no religious affiliation. Women exhibited more frequent daily experience than men, and attainment of higher levels of education was associated with less frequent daily spiritual experience. All but one of the outcome measures of physical and psychologic well-being were found to be positively associated with the DSES so that more frequent daily spiritual experience correlated with less psychopathology, more close friendships, and better self-rated health. Directions for future research, study interpretation and limitations, and clinical implications for use of the DSES are discussed.     

Internal working models of caregiving and security of attachment at age six

This study describes the relation between internal working models of caregiving, child attachment, and maternal behavior in the home. Thirty-two mothers of 6-year-old children were observed in the home and subsequently interviewed regarding experiential and affective dimensions of parenting. Interviews were examined in order to assess the quality of the mother's thinking regarding two dimensions of caregiving (secure base, competence) which we hypothesized to be related to attachment security. Results indicated a strong correspondence between internal working models of caregiving and child mental representations of attachments as measured from the child's response to a laboratory reunion. The correspondence between mental representations of caregiving and maternal behavior in the home was limited. Representation ratings were most strongly associated with competence-supporting behavior. Implications for infant mental health research and program evaluation are discussed.