Toward a Reconstruction of Medical Morality

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary.     

Couples of Mixed HIV Status

Abstract

As individuals with HIV are living longer due to earlier diagnosis and advances in treatment, they are turning their attention to living with HIV/AIDS. Based on a study (n = 82) that explored how HIV may affect the intimacy of long-term couples of mixed HIV status, psychosocial issues are identified. Key findings include the identification of six themes. They are: (1) fear of HIV transmission, (2) HIV and health status, (3) shifts in emotional intimacy, (4) assumption of care-giver and patient roles, (5) reproductive issues, and (6) a perceived sense of power inequity present between the genders and between HIV positive and HIV negative partners. Implications for the practitioner are discussed.     

Multicultural Issues in Evidence-Based Interventions

SUMMARY

School psychologists involved in the delivery of psychological and educational interventions face the challenge of identifying interventions that will work within their schools. The evidence-based intervention (EBI) approach has received attention as a promising way to identify effective interventions. The national Task Force on Evidence Based Interventions in School Psychology (sponsored by the American Psychological Association Division 16 and the Society for the Study of School Psychology, and endorsed by the National Association of School Psychologists) has developed coding criteria to review, evaluate, and identify efficacious interventions. This paper expands the work of the Multicultural and Diversity Committee of the EBI Task Force and offers direction for school psychologists in selecting and implementing interventions appropriate for their settings. We explore the meaning of EBIs in the context of a diverse world and discuss the cultural considerations that are necessary to responsibly adopt an EBI perspective. The paper is organized into three sections where we (a) examine EBIs from a multicultural perspective, (b) describe recent advances in infusing a multicultural perspective into EBI work and the Procedural and Coding Manual for Review of EBIs, and (c) offer a set of guidelines for making decisions about implementing an EBI in a new setting.     

Organizational Identification and Perceived Intra-School Conflict Among Secondary Special Education and General Education Teachers

The relationships between the organizational variables-teacher assignment (general education or special education) and primary organizational identification (teachers' individual schools or respective district-level departments) and perceived organizational conflict were investigated. Four-hundred and fifty-four high school teachers—382 general education and 72 special education—responded to a three-part questionnaire. Both general education and special education teachers identified with both the school and the district-level departments to a greater than neutral level; the general education teachers identified more with their local schools than their district-level departments and the special education teachers identified equally with both their local school and the district-level department. Significant correlations between teacher organizational identification and perceived conflict were found for both groups of teachers—as the identification increased, the perception of conflict decreased. No significant differences were found in comparisons of general education and special education teachers on the identification or perceived conflict variables. Conclusions, with alternative causative factors, and recommendations for enhancing relationships between general educators and special educators are provided.     

Soup,Stitches, and Song

Abstract

This article discusses ways that clinical practitioners can utilize creative strategies in working with clients who are experiencing grief following the death of their adolescent child. It presents a brief literature review regarding this specific type of parental grief as well as practical and helpful ways to utilize books, songs, and tangible projects in the grieving process.     

Chapter 2: Sex and the Elderly: No Laughing Matter in Religion

SUMMARY

This article provides a brief background for the study of sex and older persons. It examines the prevailing attitudes among older persons and society in general. A number of critical issues regarding sexuality in the latter years of life is addressed.     

Physical,Psychological and Social Adaptation of African American Nuns to Their Religious Communities as They Age: Implications for Aging in Place

ABSTRACT

This study examined the association between health status, stress, depression, satisfaction with the relationship with the religious community, alienation from significant persons, racial/cultural identity and “aging in place,” as measured by length of time in the same religious community, for a purposive sample of 72 African American nuns. Aging in place was significantly associated with perceptions of better health status, less stress and depression and greater satisfaction with relationships with the religious community. However, the study also found that the longer the nuns lived in their respective communities, the less racially/culturally identified they became. These findings underscore the need for finding ways to keep nuns in their religious communities as they age and to provide avenues of racial/cultural expression for African American nuns.     

Coding Counsellor Behaviour in Motivational Interviewing Sessions: Inter‐Rater Reliability for the Swedish Motivational Interviewing Treatment Integrity Code (MITI)

The aim of this study was to evaluate inter‐rater reliability when using the Swedish version of the Motivational Interviewing Treatment Code (MITI) as an adjunct to MI training, clinical practice and research. Coders were trained to use the MITI for scoring taped sessions. The 4‐month basic training had a duration of 39 hours. Following training, 60 audio‐taped live interviews were randomly assigned for MITI coding. Mean intra‐class correlation (ICC) coefficients were calculated for 7 coders across all pairs of coders. Cronbach's alpha was calculated to estimate the covariance between each pair across their common interviews. Six months later, a second inter‐rater reliability test was performed, when 5 coders coded the same 15 randomly selected tapes. At the second reliability testing the mean ICC was 0.81 and the mean Cronbach's alpha was 0.96. However, the ICC varied for different sub‐variables of the MITI, ranging from 0.42 empathy to 0.79 for number of Closed questions. In conclusion, MITI shows promising potential to be a reliable tool to confirm and enhance MI training as well as practice in clinical settings and in evaluating MI integrity in clinical MI research. However, coder assessment of empathy and MI‐spirit, “global” variables, requires further refinement.     

线索在多媒体学习中的作用

线索在多媒体学习中作为一种重要的教学设计形式,具有引导注意、组织和整合信息的功能。综述已有研究发现,线索具有引导学习者加工特定位置信息、忽视无关信息干扰的功能;在特定条件下帮助学习者整合图-文信息,并且提高学习者的学习效果;但对于线索信息组织功能尚缺少充分而有力的证据。关于线索对学习效果的影响,大部分研究证实线索能够促进学习。但是由于线索的多样性以及学习材料的复杂性,线索能否有效地提高学习效果仍然存在争议。从认知负荷理论视角综述发现,线索加入并没有明显降低学习者感知到的主观认知负荷;从知觉加工视角而言,线索作为突显的刺激会吸引学习者的注意,从而简化学习者在知觉加工阶段的视觉搜索。未来研究仍然需要关注以下问题:(1)线索是否真的被学习者所注意和加工?(2)重视学习材料多样性比较和不同线索类型差异探讨,(3)关注学习者经验影响,(4)如何在教学设计上保证线索的有效性。