Service Delivery Outcomes in ASD: Role of Parent Education,Empowerment, and Professional Partnerships

Children with Autism Spectrum Disorder (ASD) utilize a greater number of healthcare services compared to children with other developmental disabilities. Despite this, children with ASD remain at high risk for unmet service needs, which are compounded by differences in socioeconomic status (SES). Both empowerment and parent-professional partnership play a role in service outcomes and may be especially important in understanding these service disparities. Our goal was to better understand the contributions of these variables to service disparities in families of children with ASD. Two-hundred forty-nine parents of children with ASD between the ages of 3 and 20 participated in this online survey. Results support previous research highlighting high levels of unmet needs that are exacerbated by differences in parent education, a common indicator of SES. Empowerment and parent-professional partnership also predicted service delivery outcomes. While high quality partnership predicted greater service adequacy, empowerment was inversely related to services. Furthermore, an interaction found that highly empowered families experiencing poor quality partnerships reported worse service delivery outcomes, while empowerment was not a factor in services for families experiencing high quality partnerships. Parent-professional partnership partially mediated the relationship between parent education and service delivery outcomes. As such, increasing parent-professional partnerships through family-centered care and professional training may help to reduce education-related service disparities and improve satisfaction with care for families and children with ASD.     

“Big eye” surgery: the ethics of medicalizing Asian features

The popularity of surgical modifications of race-typical features among Asian women has generated debates on the ethical implications of the practice. Focusing on blepharoplasty as a representative racial surgery, this article frames the ethical discussion by viewing Asian cosmetic surgery as an example of medicalization, which can be interpreted in two forms: treatment versus enhancement. In the treatment form, medicalization occurs by considering cosmetic surgery as remedy for pathologized Asian features; the pathologization usually occurs in reference to western features as the norm. In the enhancement form, medicalization occurs by using medical means to improve physical features to achieve a certain type of beauty or physical appearance. Each type of medicalization raises slightly different ethical concerns. The problem with treatment medicalization lies in the pathologization of Asian features, which is oppressive as it continues to reinforce racial norms of appearance and negative stereotypes. Enhancement medicalization is ethically problematic because cosmetic surgery tends to conflate beauty and health as medical goals of surgery, overemphasizing the value of appearance that can further displace women’s control over their own bodies. I conclude that in both forms of medicalization, cosmetic surgery seems to narrowly frame a complex psychosocial issue involving physical appearance as a matter that can be simply solved through surgical means.     

Fact-Dependent Policy Disagreements and Political Legitimacy

Suppose we have a persistent disagreement about a particular set of policy options, not because of an underlying moral disagreement, or a mere conflict of interest, but rather because we disagree about a crucial non-normative factual assumption underlying the justification of the policy choices. The main question in the paper is what political legitimacy requires in such cases, or indeed whether there are defensible answers to that question. The problem of political legitimacy in fact-dependent policy disagreements has received almost no attention in political philosophy, which has focused mostly on value disagreements and proposed theories of legitimate coercive legislation in valuedependent disagreements. The paper presents an argument showing that under certain plausible assumptions regarding legitimacy, there are serious difficulties in identifying legitimate choices in fact-dependent policy disagreements. This may be unsurprising to political philosophers preoccupied with value-based disagreements, perhaps because it has been assumed that legitimacy-related concerns are irrelevant (or do not apply) to fact-dependent policy disagreements. The paper argues that this response is premature. If we should care about legitimacy et al.l, then it is by no means clear why we should ignore issues of legitimacy in policy-disputes that depend on factual disagreements. The paper ends by defining a set of possibilities that merit further exploration in search of a theory of legitimacy in fact-dependent policy disagreements.     

The primacy question in Merleau-Ponty’s existential phenomenology

This paper takes up the question as to what has primacy within Merleau-Ponty’s existential phenomenology as a way to provide insight into the relation between empirical science and transcendental philosophy within his account of embodiment. Contending that this primacy necessarily pertains to methodology, I show how Kurt Goldstein’s conception of biology provided Merleau-Ponty with a scientific model for approaching human existence holistically in which primacy pertains to the transcendental practice of productive imagination that generates the eidetic organismic Gestalt in terms of which sense is made of empirical facts. Considering the analogous role played by imagination in Merleau-Ponty’s account of perceptual synthesis in the form of what he called projection, I argue that his account of embodiment is, parallel to Goldstein, grounded methodologically on the projection of an organismic Gestalt, and that as a form of operative-intentional praxis projection is the site of primacy in his phenomenology overall. In terms of the relation between natural science and transcendental philosophy in Merleau-Ponty’s account of embodiment, while the theoretical dimension of the latter—the eidetic apriority of the organismic Gestalt—is coupled dialectically with empirical facts on an epistemically coeval basis, these are jointly subordinated to the normative commitments implied by the imaginative projection of that Gestalt. The primacy of the latter is transcendental but in a distinctly practical sense, such that any substantive discrepancy between natural science and Merleau-Pontian phenomenology reflects metaphilosophical, not theoretical, disagreement.     

A computational framework for attentional object discovery in RGB-D videos

We present a computational framework for attention-guided visual scene exploration in sequences of RGB-D data. For this, we propose a visual object candidate generation method to produce object hypotheses about the objects in the scene. An attention system is used to prioritise the processing of visual information by (1) localising candidate objects, and (2) integrating an inhibition of return (IOR) mechanism grounded in spatial coordinates. This spatial IOR mechanism naturally copes with camera motions and inhibits objects that have already been the target of attention. Our approach provides object candidates which can be processed by higher cognitive modules such as object recognition. Since objects are basic elements for many higher level tasks, our architecture can be used as a first layer in any cognitive system that aims at interpreting a stream of images. We show in the evaluation how our framework finds most of the objects in challenging real-world scenes.     

The social impact and the intrusive dimension of enhancement

A key feature of Buchanan (2011) is emphasis put on the social impact of biomedical enhancement. This social turn enables Buchanan to reframe the question of the desirability of enhancers. The fundamental question is no longer an individual question (do I want to use X, and why, and would it be right?) but a social question: what would be the advantages and the drawbacks of X in our society? The individual question, in Buchanan’s analysis, is second to the social question. Now, if one accepts that an enhancer may have secondary effects, or drawbacks, the social question requires a cost and benefit analysis. I will argue that there are two flaws in Buchanan’s position: 1) the way in which he envisions the social debate about biomedical enhancement, and a cost and benefit analysis, would only be adequate in a kind of utopia which no actual existing State seems to match; 2) The cost and benefit analysis needs to be complemented not by an individual ethics but by narratives accounting for the experience of the subject. The level on which takes place Buchanan’s discussion covers up an individual experience which needs to be articulated and taken into account. It is this kind of individual, or singular, narrative that I will look for in the work of the post-phenomenological philosopher Jean-Luc Nancy, thus attempting to bridge a gap between two different philosophical traditions and styles of writing.     

Invariance of the “NEO-PI-R” factor structure across exploratory and confirmatory factor analyses

Confirmatory factor analyses (CFA) carried out in the last decades to test the Five-factor simple structure have generally obtained negative results. McCrae, Zonderman, Costa, Bond, and Paunonen (1996) suggested that CFA limitations were the main cause of such negative results. They also claim that Procrustes Orthogonal rotation method is an adequate procedure to test the replicability of the Five-factor structure. The aim of the present paper is twofold: (A) comparing several Exploratory factor procedures (including the Procrustes rotation) to test what is the most appropriate one to analyse the replicability of the Five-factor structure, and (B) replicating the CFA results of the McCrae et al.’s study with a larger number of subjects. The normative American (N = 1000), and Spanish (2000) standardization samples of the NEO-PI-R, together with an independent university sample (N = 948) were analysed. Results were replicated in the three samples, and suggest that: (1) structural properties of the Five-factor model, as measured by the NEO-PI-R, are invariant irrespective of the Exploratory factor procedure used, and (2) when CFA limitations are surpassed, the Five-factor structure is supported.     

Positive psychotherapy for distressed cancer survivors: Posttraumatic growth facilitation reduces posttraumatic stress

Background/Objective

There is increasing evidence that positive life changes, such as posttraumatic growth (PTG), can result from the experience of coping with cancer. However, no interventions have been specifically designed to facilitate the development of PTG in cancer. In this article, we describe and assess the results of Positive Psychotherapy for Cancer (PPC) survivors. It aims to facilitate PTG as a way of achieving significant reductions in the symptoms of emotional distress and posttraumatic stress. In addition, the corroboration of this PTG facilitation is assessed using interpersonal indicators. Method: We allocated 126 consecutive survivors of cancer with high levels of emotional distress and who were seeking psychological support to either an experimental group (PPC) or a waiting list group. Results: The PPC group obtained significantly better results after treatment than the control group, showing reduced distress, decreased posttraumatic symptoms, and increased PTG. The benefits were maintained at 3 and 12 months’ follow-up. Participants’ PTG was correlated to the PTG that their significant others attributed to them, corroborating PTG facilitation. Conclusions: PPC appears to promote significant long-term PTG and can reduce emotional distress and posttraumatic stress in cancer survivors. In addition, PTG facilitation induced by PPC is corroborated by significant others.     

Inventory of Overburden in Alzheimer's Patient Family Caregivers with no Specialized Training

Background/Objective: Alzheimer-type dementia is one of the most frequent causes of dependence in an aging population, which combines with a considerable demand for care. Furthermore, when the caregiver is a family member or person without specialized training, such care impacts on that person's health. The Inventory of Overburden in Alzheimer's Patient Family Caregivers with no Specialized Training (IPSO-CA24) was designed to find out the needs of these caregivers and evaluate the caregiver's burden or distress. Method: The psychometric properties of the questionnaire were analyzed (in a reliability analysis, exploratory factor analysis and confirmatory analysis) based on the responses of 255 caregivers. Results: The factor analyses showed a six-factor structure (Reaction to diagnosis, Physical health, Psychological symptomatology (caretaker), Behavioral symptomatology (patient), Knowledge of the illness, and Level of dependence) explaining 66.52% of the total variance with a reliability of .75 to .93. Support was also found for its convergent validity. Conclusions: The IPSO-CA24 responds to the need for an instrument enabling multidimensional evaluation of the burden on the family caregiver without specialized training.     

Estimating the effect of emotional intelligence in wellbeing among priests

Background/Objective: Emotional intelligence is a variable which has been the subject of significantly increased research in recent years. Relationships have been shown with both physical and psychological problems. The aim of this study is to analyse the direct and indirect effect that emotional intelligence exerts over the manifestation of physical and psychological clinical symptomatology and to severe disorders such as burnout syndrome in a professional group in which social function is fundamental. Method: So that, 881 Latin-American catholic priests (M_age = 45.89; SD_age = 11.58) were evaluated using the Trait Meta-Mood Scale-24, the Maslach Burnout Inventory-22 and the General Health Questionnaire-28. Results: Using path analysis, emotional intelligence, especially Attention and Emotional Clarity, shows a high effect on psychological and somatic issues. Conclusions: Thus, both specific disorders and general well-being are related to emotional intelligence. Providing effective emotional intelligence training sessions seems to be able to reduce possible physical and emotional disorders.