Re-Evaluating Professional Autonomy in Health Care

Professional autonomy, as the symbol of the traditional freedom ofdecision-making of medical professionals is criticized. This essayexamines the critique. It analyses the underlying assumption that theautonomy of health professionals is incompatible with the need fororganisation and management in order to control rising health carecosts. It is argued that the concept of professional autonomy should beredefined, not through restricting the decision-making freedom ofindividual health professionals, but through expanding the concept intothe sphere of management, so that managers will take responsibility forpatient care.     

成就目标定向在学业自我概念与学业成绩关系中的调节作用:基于内/外参照模型

为了探究成就目标定向在学业自我概念与学业成绩关系中的调节作用,采用语文学业自我概念量表、数学学业自我概念量表和成就目标定向量表对1515名初中生进行测查。结果显示：(1)初中生语文-数学学业自我概念建构过程符合内/外参照模型(Internal/External Frame of Reference Model, I/EM);(2)掌握回避对I/EM的维度比较路径存在调节作用,掌握回避得分越高越易受维度比较效应的影响,该现象对于语文成绩和数学成绩相对差的学生更明显;(3)成绩回避对I/EM的社会比较路径存在调节作用,成绩回避得分越高越不易受社会比较效应的影响,该现象对于语文成绩和数学成绩相对好的学生更明显。本研究揭示了持有不同成就目标定向的初中生在学业自我概念建构过程中的差异,对引导初中生建构积极学业自我概念具有重要启示。     

The functions of internal dialogs and their connection with personality

In previous studies, seven key functions in internal dialogs were identified: Support, Substitution, Exploration, Bond, Self‐improvement, Insight, and Self‐guiding. It was also established that internal dialogs vary in the intensity of these functions. The presented research aimed to test if there are configurations of personality variables that allow us to predict specific patterns of functions performed by internal dialogs. Canonical correlation analysis revealed that the higher the intensity of neuroticism and anxious attachment and the lower the intensity of openness and the tendency to spontaneously adopt the viewpoints of others, the more strongly a person's internal dialogs perform the Substitution function and the weaker the Insight and Support functions are. The reverse configuration of personality characteristics intensifies Insight and Support and minimized Substitution. The results are presented in the context of the status of dialogicality and discussed in the light of other studies on internal dialogs.     

Internal Consistency and Power When Comparing Total Scores from Two Groups

Researchers now know that when theoretical reliability increases, power can increase, decrease, or stay the same. However, no analytic research has examined the relationship of power to the most commonly used type of reliability—internal consistency—and the most commonly used measures of internal consistency, coefficient alpha and ICC(A,k). We examine the relationship between the power of independent samples t tests and internal consistency. We explicate the mathematical model upon which researchers usually calculate internal consistency, one in which total scores are calculated as the sum of observed scores on K measures. Using this model, we derive a new formula for effect size to show that power and internal consistency are influenced by many of the same parameters but not always in the same direction. Changing an experiment in one way (e.g., lengthening the measure) is likely to influence multiple parameters simultaneously; thus, there are no simple relationships between such changes and internal consistency or power. If researchers revise measures to increase internal consistency, this might not increase power. To increase power, researchers should increase sample size, select measures that assess areas where group differences are largest, and use more powerful statistical procedures (e.g., ANCOVA).     

Adult Attachment and Dyadic Adjustment: The Mediating Role of Shame

Although it is widely recognized that adult attachment is associated with romantic relationship quality, the mechanisms involved remain poorly understood. This study aimed to investigate the mediating role of external and internal shame on the association between attachment and dyadic adjustment. A battery of self-report measures was completed by 228 Portuguese participants and a serial multiple mediation model was tested. Data showed that, in the population under study, attachment dimensions were associated with worse dyadic adjustment through high external and internal shame. Internal shame alone also mediated the association between attachment avoidance and dyadic adjustment. This study identifies a new putative mechanism linking adult attachment and intimate relationship functioning that may be targeted in couples therapy to promote a better dyadic adjustment and relationship functioning.     

The Map and the Territory: Complexity in Biology

In business administration or in economics it is absolutely relevant not to consider indexes like profit growth rate or gross domestic product as exhaustive indexes for economic wealth. Likewise, in biology it is important not to confuse the representation of life with life itself. The most important concepts in biology are information, memory, structure, plasticity, and robustness. Information is the difference that makes the difference. Memories are information registered in an organism. Plasticity is the capacity of a living organism to change its own structure/sets of behaviors for having a competitive advantage. Robustness is the ability of a living organism to resist environmental changes without changing its own structure/sets of behavior, and fragility is when a living organism undergoes changes in its own structure without being able to resist non-adaptive changes.     

Work and nonwork stressors,negative affective states,and pain complaints among firefighters and paramedics

Prior research has suggested that occupational stressors may contribute to the etiology, progression, and chronicity of pain problems in workers. This study used anonymous survey methods to assess the prevalence and frequency of self-reported pain symptoms and their relationships to demographic variables, sources of occupational stressors, nonwork stressors and affective distress in a large sample (N2000) of employed career public sector firefighters and paramedics. The findings were consistent with those of previous studies of high strain workers. More than 95% of the firefighter/paramedic sample reported at least one pain complaint (using a 1 week assessment time frame). A hierarchical multiple regression analysis entering demographic, occupational, and nonwork stressors, as well as measures of negative affective states targeting total pain scores, yielded significant relationships. Five occupational stressors were associated with respondent pain complaints. The results also suggest that negative affective states mediated the relationships between work and nonwork variables, and pain complaint outcomes. The implications of these findings for the development of preventive interventions for firefighters and paramedics as well as other emergency service workers are considered.     

On the Logical Positivists' Theory of Truth: The Fundamental Problem and a New Perspective

The present article purports to show that the protocol sentence debate, pursued by some leading members of the Vienna Circle in the mid-1930s, was essentially a controversy over the explanation and the real significance of the concept of truth. It is further shown that the fundamental issue underlying the discussions about the concept of truth was the relationship between form and content, as well as between logic/language and the world. R. Carnap was the philosopher who most explicitly and systematically attempted to come to grips with this problem. It is shown that the form-content distinction pervades the three most important phases of Carnap's philosophical development: the structuralist (in Der logische Aufbau der Welt), the syntactical and the semantical. His final semantical stance is essentially determined by the concept of linguistic frameworks. The article purports to demonstrate that this concept cannot be dispensed with in philosophy, but that Carnap failed to work out its ontological implications. Finally, the concept of an internal ontology is briefly delineated. This revised version was published online in August 2006 with corrections to the Cover Date.     

Three Conceptions of Rational Agency

Rational agency may be thought of as intentional activity that is guided by the agent's conception of what they have reason to do. The paper identifies and assesses three approaches to this phenomenon, which I call internalism, meta-internalism, and volitionalism. Internalism accounts for rational motivation by appeal to substantive desires of the agent's that are conceived as merely given; I argue that it fails to do full justice to the phenomenon of guidance by one's conception of one's reasons. Meta-internalism explains this phenomenon by postulating higher-order dispositions, consitutive of (rational) agency itself, which causally interact with the agent's normative beliefs to produce corresponding motivations to action. I show that meta-internalism comes to grief over cases of akrasia, insofar as it leaves no room for the capacity for rational guidance when agents voluntarily act at variance with their judgments about what they have reason to do. Volitionalism, I contend, improves on both internalism and meta-internalism. Its distinctive feature is the postulation of a kind of motivation that is directly subject to the agent's control, and independent of the dispositions and desires to which the agent is passively subject.     

Organizational response to recommendations based on a study of stress among correctional officers

A study was recently commissioned by the South Australian Government to study the nature and sources of stress among correctional (prison) officers. The paper reports on the key variables found to have significant predictive effects on strain (a composite measure comprising psychological distress, physical ill-health symptoms, job dissatisfaction, and work-home conflict). These included demographic variables (length of service, finances), personal variables (negative affectivity), work environment variables (work role ambiguity, institutional relationship concerns, inmate concerns, worktime concerns, low autonomy, and low involvement), and emotional suppression. Recommendations were formulated including: the appointment of a full-time mental health counselor, organizational and individual strategies aimed to improve supervisor support and management training, greater participation in organizational decision making, and post-shift debriefing. It was also suggested that in selecting correctional officers those displaying high levels of negative affectivity should be screened out. Finally, it was recommended that intervention should target the most vulnerable individuals, including shiftworkers, officers who had been employed in the organization the longest, officers currently on stress leave and officers, who have previously been on stress leave and have returned to work. The paper reports on the organizational response to the recommendations and the implications of the study are discussed in the context of ongoing surveillance and evaluation of the impact of intervention strategies.