医学伦理学概念之探究

医学伦理学的概念看起来很简单,一般情况下人们便习以为常地接受了作为应用规范伦理学的一个分支的科学地位,而忽视了医学对医学伦理学所起的作用。本文认为：医学伦理学的具体内容是医学科技与伦理道德两因素相互作用的产物,对其相互作用的形式和产物的具体分析和总结便可构成这门学科的理论体系。     

CLASSWIDE PEER TUTORING: AN INTEGRATION STRATEGY TO IMPROVE READING SKILLS AND PROMOTE PEER INTERACTIONS AMONG STUDENTS WITH AUTISM AND GENERAL EDUCATION PEERS

A multiple baseline design across subjects with a reversal was used to examine the effects of classwide peer tutoring relative to traditional reading instruction on reading skills and social interaction time for 3 high-functioning students with autism and their typical peers in integrated, general education classrooms. Traditional reading instruction consisted largely of teacher-led instruction with individual student participation and seat work. Classwide peer tutoring consisted of 25 to 30 min of well-specified instruction in which tutor—learner pairs worked together on a classwide basis on reading fluency and comprehension skills. All students participated in 15- to 20-min unstructured free-time activities immediately following reading instruction. Results of reading assessments demonstrated that classwide peer tutoring increased reading fluency and correct responses to reading comprehension questions for students with autism and their peers. The procedure further increased the total duration of free-time social interactions for students with autism and typical peers, with individual variation in performance.     

EFFECTS OF HIGH-PROBABILITY REQUESTS ON THE SOCIAL INTERACTIONS OF YOUNG CHILDREN WITH SEVERE DISABILITIES

High-probability requests were used to increase social interactions in 3 young boys with severe disabilities who had been identified as severely socially withdrawn. A multiple baseline design across participants was used to evaluate the effects of high-probability request intervention on (a) social initiations, (b) social responses, (c) continued interactions, and (d) performance of high- and low-probability requests. The students were observed in a second setting to examine generalization effects across peers who did not participate in the training sequence and settings. The results demonstrated that the high-probability requests increased the students' responsiveness to low-probability requests to initiate social behavior. Increases were also found in (a) unprompted initiations and extended interactions to the training peers, (b) unprompted initiations and extended interactions to peers who were not involved in the training procedure, and (c) generalized unprompted initiations and interactions in a second nontraining setting. The students maintained increased levels of initiations and interactions after all prompts were removed from both the training and nontraining settings.     

THE JOHN TEMPLETON FOUNDATION MODEL COURSES IN SCIENCE AND RELIGION

Abstract. In 1994 the John Templeton Foundation Humility Theology Information Center launched a major initiative, the Science-Religion Course Program, to encourage the teaching of high-quality academic courses focusing on the relationship between science and religion. In the first phase of the program, six courses were selected—four from the United States, one from Canada, and one from New Zealand—to serve as models for other academics wishing to initiate their own classes on the science-religion interface. In particular these six model courses will serve as examples for the second phase of the Templeton Foundation program, which will provide financial support for up to 100 courses at universities, colleges, and seminaries around the world. This paper is a report on the pedagogical strategies and methodologies employed in each of the six selected model courses.     

Preventing antisocial behavior in the schools

Multiple correlates and determinants of antisocial behavior within the home, community, and school are reviewed. Due to the school's pivotal role in our society, an emphasis is placed on how our schools contribute to antisocial behavior, and what educators can do to prevent anti-social behavior and related attendance problems. A variety of contextual factors and setting events within our schools appear to be major contributors to antisocial behavior, and some of the same factors identified within the schools also have been identified within the home. These setting events, rather than quick restrictive fixes, must be given more attention if we are to provide safe school environments-environments that durably prevent antisocial behavior and related attendance problems.     

Patterns of mother-infant interaction and attachment: A cluster-analytic approach

This study examined stability and change in patterns of mother-infant interaction between 5 and 10 months and their relation to attachment security at 18 months. Cluster analysis was used to identify patterns of dyadic interaction. There was significant, but not substantial, stability in cluster membership from 5 to 10 months. For females, being in the most optimal cluster at 5 months related to subsequent attachment security, regardless of the 10-month pattern of interaction. For males, who were significantly more likely to be insecure than females, insecure attachment was predicted by negative change from 5 to 10 months (moving from a more optimal to a less optimal cluster).     

Persistent crying and parenting: Search for a butterfly in a dynamic system

The risks and causes of persistent crying in early infancy are discussed on the basis of a study of 61 infants referred to the Munich Interdisciplinary Research and Intervention Program for Fussy Babies for persistent crying between 1 and 6 months of age, and of a community sample of 51 infants of the same age. Particular attention was paid to pre-verbal parent-infant communication, the development of which was interpreted in terms of a dynamic interactional system including both regulatory and communicative predispositions in infants and intuitive competence for supporting infant predispositions in parents. Neither a gut problem nor any other single causal factor was identified for persistent crying in the majority of cases. In contrast, persistent crying was significantly associated with multiple biological and psychosocial risk factors for both parents and infants. Neurological immaturity, difficult temperament and sleep problems in infants, and impaired psychological conditions, limited resources and failures of intuitive competences in mothers were found to threaten the developmental process in infants and give rise to ‘vicious circles’ which were destabilizing the interactional systems. Increased attention to intuitive parental competences is recommended as one effective model for therapeutic interventions.     

Cooperative learning revisited

The endeavor to teach academic skills known as cooperative learningis of interest to behavioral educators due to its record of effectiveness, its use of behavioral procedures, and its relatively widespread adoption by regular educators. All forms of cooperative learning emphasize operations that encourage students to work together to achieve commonly held goals rather than competing with or ignoring the efforts of others. Despite the apparent soundness of the approach, the present commentary raises several issues. First, it states that some cooperative learning proponents fail to describe the behavioral processes underlying the approach. Second, it is pointed out that it is unclear whether cooperative learning is an independent or dependent variable. Given that cooperative learning applies group contingencies to academic behavior, the question is raised as to whether group contingencies do, in fact, produce desirable social interactions, and whether group contingencies are appropriate for academic behaviors. A concern is also raised as to whether the spontaneous peer tutoring generated by cooperative learning compares favorably with planned peer tutoring. Finally, it is claimed that the minor variations from academic group contingencies that cooperative learning proponents have introduced do not require identifying a new process.     

Decompositions and biplots in three-way correspondence analysis

In this paper correspondence analysis for three-way contingency tables is presented using three-way generalisations of the singular value decomposition. It is shown that in combination with Lancaster's (1951) additive decomposition of interactions in three-way tables, a detailed analysis is possible of the deviations from independence. Finally, biplots are shown to produce powerful graphical representations of the results from three-way correspondence analyses. An example from child development is used to illustrate the theoretical developments.     

Attentiveness of mothers and fathers to their baby's cries

Thirty-two mother-father-infant triads participated in a study to examine whether parents' responsiveness to their own infant's distress was affected by the infant's birth order and gender. After separating from their 10- to 11-month-old baby, one parent from each family (16 mothers and 16 fathers) was selected to hear cries that were attributed to the child. Consistent with previous findings regarding physiological reactions to crying and observations of caretaking behavior, first-time parents gave quicker and more frequent attention to their infants than did multiporous parents. Speedy intervention was related to the amount of caretaking responsibilities that parents reported they assumed and to the age at which parents believed that their infant first recognized them. The results demonstrate the importance of caretaking for promoting parental sensitivity to infant signals.