Concordant Spiritual Orientations as a Factor in Physician--Patient Spiritual Discussions: A Qualitative Study

Objectives: To understand the impact of physicians and patients religious/spiritual orientation on discussions of spiritual issues. Methods: We performed semi-structured interviews of 10 Missouri family physicians and 10 patients of these physicians, selecting subjects nonrandomly to represent a range of demographic factors, practice types, and chronic or terminal illness. We coded and evaluated transcribed interviews for themes. Results: Respondents expressed that similar belief systems facilitate patient–physician spiritual interactions and bring confidence to their relationships. Those holding dissimilar faiths noted limited ability to address spiritual questions directly. They cited significant barriers to spiritual interaction but considered that ecumenism, use of patient-centered care, and negotiation skills lessen these barriers. Conclusions: Our respondents view spirituality similarly to other aspects of the physician–patient relationship involving differing viewpoints. Where discordance exists, cross-cultural, patient-centered, diplomatic approaches facilitate spiritual discussions.     

From <Emphasis Type="Italic">Pintele Yid to Racenjude</Emphasis>: Chaim Zhitlovsky and racial conceptions of Jewishness

The Russian Jewish intellectual, Chaim Zhitlovsky (1865–1943), a leading architect of secular Jewish culture and thought, was a central figure in the progressive Jewish intelligentsia of the late nineteenth and early twentieth century. In an essay written in 1927, Yidn un Yiddishkayt (Jews and Jewishness), he sought to define the secular essence of what he calls Yiddishkayt. This essay is not the first in Zhitlovskys long publicistic career in which he searches for new, secular definitions of Jewish identity and culture. But this essay differs, since it is marked by Zhitlovskys use of contemporary social scientific notions of race and racial traits to conceptualize what he believes constitutes Jewishness in a non-religious context, along with his adoption of the mystical Jewish concept of the pintele yid, the theory of an innate Jewishness embodied by a Jewish spark. Zhitlovskys desire to craft a truly secular theory of Jewish identity led him ironically to accept models of Jewish identity at odds with his stated larger vision. In turning to contemporary racial theory, as well as long nurtured mystical models of Yiddishkayt, Zhitlovsky reveals the wide range of ideological discourses that led him to innovative and controversial notions of modern Jewish identity.     

Index of suspicion: feeling not believing

Throughout the U.S., state laws require professionals who work with children to report cases of suspected child abuse to child protection services. Both practically and conceptually, however, significant problems arise from a lack of clarity regarding the threshold that has been set for reporting. Specifically, there is no consensus as to what constitutes reasonable suspicion, and little direction for how mandated reporters should gauge their legal and professional responsibilities when they harbor suspicion. In this paper we outline the context of the problem, discuss the nature and scope of its conceptual underpinnings, and offer recommendations for moving towards a concrete, practical solution.     

Senior capstone design and ethics: A bridge to the professional world

A senior level capstone design experience has been developed and offered with a particular emphasis on many of the professional issues raised in Accreditation Board for Engineering and Technology (ABET) Engineering Criterion IV. The course has sought to develop student awareness of the ethical foundation of the engineering profession, the global and societal framework within which engineers practice, and the environmental impact on engineering. The capstone design course also focused upon improving the technical communications skills of the graduating senior class with both extensive instruction in writing and multiple workshops dealing with the art of making an effective oral presentation. The effectiveness of the design course was assessed using Kirkpatrick’s model for evaluating training programs. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

Perceptions of Ethical Behaviour among Business Faculty in Canada

Faculty members at Canadian business schools were surveyed regarding their ethical perceptions of behaviours related to undergraduate instruction. Fifty-five behavioural statements were listed and respondents were asked to rate the extent to which they felt each behaviour was ethical or unethical. The only item that respondents endorsed as unequivocally unethical (90% indicated it was definitely unethical) was Becoming sexually involved with an undergraduate in one of your classes. We also compared the results of our sample to those of an American sample. Overall, an interesting pattern of differences emerged between the responses obtained in Canada and the U.S. In general, the direction of the significant differences was such that Canadian professors viewed the behaviours in question as less ethical than did their American counterparts.     

The nature and treatment of stuttering as revealed by fMRI A within- and between-group comparison

This article reviews some of our recent functional magnetic resonance imaging (fMRI) studies of stuttering. Using event-related fMRI experiments, we investigated brain activation during speech production. Results of three studies comparing persons who stutter (PWS) and persons who do not stutter (PWNS) are outlined. Their findings point to a region in the right frontal operculum (RFO) that was consistently implicated in stuttering. During overt reading and before fluency shaping therapy, PWS showed higher and more distributed neuronal activation than PWNS. Immediately after therapy differential activations were even more distributed and left sided. They extended to frontal, temporal, and parietal regions, anterior cingulate, insula, and putamen. These over-activations were slightly reduced and again more right sided two years after therapy. Left frontal deactivations remained stable over two years of observation, and therefore possibly indicate a dysfunction. After therapy, we noted higher activations in persons who stutter moderately than in those who stutter severely. These activations might reflect patterns of compensation. We discuss why these findings suggest that fluency-inducing techniques might synchronize a disturbed signal transmission between auditory, speech motor planning, and motor areas.

Educational objectives: The reader will learn about and be able to: (1) identify regions of brain activations and deactivations specific for PWS; (2) describe brain activation changes induced by fluency shaping therapy; and (3) discuss the correlation between stuttering severity and brain activation.     

NR2B downregulation in a forebrain region required for avian vocal learning is not sufficient to close the sensitive period for song learning

The neural changes that limit the sensitive period for avian song development are unknown, but neurons in a forebrain region critical for song learning, the lMAN, exhibit experience-driven changes in NMDAR subunit expression that could regulate sensitive period closure. Specifically, NR2B levels in lMAN decrease during song acquisition, potentially reducing synaptic plasticity by decreasing NMDAR EPSC duration and/or affecting NMDAR-coupled intracellular cascades. While rearing birds in isolation extends the sensitive period and also delays the developmental changes in NR2B expression and NMDAR physiology, recent work indicates that a transition to faster NMDAR currents does not preclude further song learning. However, NR2B mRNA expression in isolates remains elevated beyond the age at which NMDAR currents shorten, leaving open the possibility that NR2B levels regulate closure of the sensitive period through effects other than those mediated by NMDAR current duration. To determine whether the experience-driven decrease in NR2B expression in lMAN closes the sensitive period, we promoted this change in gene expression either by treating isolation-reared zebra finches briefly with testosterone (T-isolates) or by allowing males limited access to conspecific song (pre-exposed isolates). We then assessed if these birds could acquire song from tutors after the normal close of the sensitive period. Despite a normal decline in NR2B expression, T-isolate and pre-exposed isolate birds learned tutor songs heard from d65-90, while normally reared birds did not. These findings suggest that the normal decline in NR2B expression with lMAN is not sufficient for sensitive period closure.     

Visual perspective taking for avatars in a Simon task

In modern digital applications, users often interact with virtual representations of themselves or others, called avatars. We examined how these avatars and their perspectives influence stimulus–response compatibility in a Simon task. Participants responded to light/dark blue stimuli with left/right key presses in the presence of a task-irrelevant avatar. Changes in stimulus–response compatibility were used to quantify changes in the mental representation of the task and perspective taking toward this avatar. Experiments 1 and 2 showed that perspective taking for an avatar occurred in orthogonal stimulus–response mappings, causing a compatibility effect from the avatar’s point of view. In the following two experiments we introduced a larger variety of angular disparities between the participant and avatar. In Experiment 3, the Simon effect with lateralized stimulus positions remained largely unaffected by the avatar, pointing toward an absence of perspective taking. In Experiment 4, after avatar hand movements were added in order to strengthen the participants’ sense of agency over the avatar, a spatial compatibility effect from the avatar’s perspective was observed again, and hints of the selective use of perspective taking on a trial-by-trial basis were found. Overall, the results indicate that users can incorporate the perspective of an avatar into their mental representation of a situation, even when this perspective is unnecessary to complete a task, but that certain contextual requirements have to be met.     

Knowledge level learning and the power law: A soar model of skill acquisition in scheduling

Zusammenfassung. Das hier vorgestellte Modell lernt graduell, Planungsaufgaben aus der Klasse der Maschinenbelegungsprobleme (job-shop-scheduling problems) zu lösen. Mit Hilfe des Chunking-Mechanismus von Soar wird episodisches Wissen über die Belegungsreihenfolge von Aufträgen auf Maschinen memoriert. Bei der Entwicklung des Modells wurden zahlreiche qualitative (z. B. Transfereffekte) und quantitative Befunde (z. B. Bearbeitungszeiten) aus einer früheren empirischen Untersuchung berücksichtigt. In einer Validierungsstudie wurden dieselben Aufgaben von 14 Probanden und dem Modell bearbeitet. Die Passung von Simulationsdaten und empirischen Ergebnissen fiel insgesamt gut aus. Allerdings löst das Modell die Aufgaben schneller und zeigt auch einen etwas besseren Lernverlauf als die Probanden. Das Modell liefert eine Erklärung für das Rauschen, das typischerweise bei Bearbeitungszeiten zu beobachten ist: es handelt sich um erworbenes Wissen, das mehr oder weniger gut und auch unterschiedlich häufig auf neue Situationen übertragen wird. Der Lernverlauf der Probanden entspricht nur für aggregierte Daten einer Potenzfunktion (power law). Der vorgestellte Mechanismus zeigt, wie ein symbolisches Modell der Informationsverarbeitung graduelle Verhaltensänderungen generiert und wie der offensichtliche Erwerb allgemeiner Prozeduren ohne explizites Lernen von deklarativen Regeln erfolgen kann. Es wird nahegelegt, daß es sich hier um die Modellierung einer Form impliziten Lernens handelt. Summary. The model presented here gradually learns how to perform a job-shop scheduling task. It uses Soar's chunking mechanism to acquire episodic memories about the order to schedule jobs. The model was based on many qualitative (e.g., transfer effects) and quantitative (e.g., solution time) regularities found in previously collected data. The model was tested with new data where scheduling tasks were given to the model and to 14 subjects. The model generally fit these data with the restrictions that the model performs the task (in simulated time) faster than the subjects, and its performance improves somewhat more quickly than the subjects' performance. The model provides an explanation of the noise typically found in problem solving times - it is the result of learning actual pieces of knowledge that transfer more or less to new situations but rarely by an average amount. Only when the data are averaged (i.e., over subjects) does the smooth power law appear. This mechanism demonstrates how symbolic models can exhibit a gradual change in behavior and how the apparent acquisition of general procedures can be performed without resorting to explicit declarative rule generation. We suggest that this may represent a type of implicit learning.