Being, Doing, and Knowing: Developing Ethical Competence in Health Care

There is a growing interest in ethical competence-building within nursing and health care practising. This tendency is accompanied by a remarkable growth of ethical guidelines. Ethical demands have also been laid down in laws. Present-day practitioners and researchers in health care are thereby left in a virtual cross-fire of various legislations, codes, and recommendations, all intended to guide behaviour. The aim of this paper was to investigate the role of ethical guidelines in the process of ethical competence-building within health care practice and medical research. A conceptual and critical philosophical analysis of some paragraphs of the Helsinki Declaration and of relevant literature was performed. Three major problems related to ethical guidelines were identified, namely, the interpretation problem (there is always a gap between the rule and the practice, which implies that ethical competence is needed for those who are to implement the guidelines); the multiplicity problem (the great number of codes, declarations, and laws might pull in different directions, which may confuse the health care providers who are to follow them); and the legalisation problem (ethics concerns may take on a legal form, where ethical reflection is replaced by a procedure of legal interpretations). Virtue ethics might be an alternative to a rule based approach. This position, however, can turn ethics into a tacit knowledge, leading to poorly reflected and inconsistent ethical decisions. Ethical competence must consist of both being (virtues) and doing (rules and principles), but also of knowing (critical reflection), and therefore a communicative based model is suggested.     

How do 8‐month‐old infants recognize causality in object motion and that in human action?1

Abstract: In Experiment 1, 8‐month‐old infants were first habituated to the event in which a moving object collided with another behind an occluder, then they were shown the two test events with no occluder: the contact event, in which the two objects actually collided, and the non‐contact event, in which the second object started to move without contact with the first. The infants looked at both events for an equal amount of time. In Experiment 2, in which the first object was a human actor, however, infants looked at the non‐contact event reliably longer than the contact event. In Experiment 3, in which both objects were human actors stood face‐to‐back, infants looked at the non‐contact event longer, whereas in Experiment 4, in which human actors faced toward each other, infants looked at both events equally. In Experiment 5, in which the first actor told the second to go, 10‐month‐old infants looked at both events for an equal amount of time. These results suggest that 8‐ and 10‐month‐old infants appreciate different causal principles between objects and humans, and that, in doing this, they may acknowledge the possibility of communication between humans.     

Examining Religious Disaffiliation Through a Family Systems Lens: Implications for Treatment

Religious disaffiliation can be emotionally and relationally challenging. Research indicates that people who disaffiliate can experience grief, emotional distress, and even posttraumatic stress disorder (PTSD) symptoms. Research also indicates that disaffiliation can put strain on family relationships, yet exactly how this impacts the family system as a whole is much less understood. This qualitative study, using grounded theory analytic procedures, fills a gap in the literature by utilizing a systemic approach to explore the impact of religious disaffiliation on family units. Twelve participants from five different families representing five different religions were interviewed. At least one disaffiliated member and one affiliated member were interviewed from each family system. Results offered a deeper understanding of (a) the relational impact of religious disaffiliation and (b) the relational challenges of navigating interactions after disaffiliation. Six clinical implications are offered with the goal of helping family members understand their unique experience of this transitional time, process their emotions, enhance distress tolerance skills, and effectively communicate with one another in a spirit of kindness and respect to prevent relational wounds, expedite the healing process, and protect family bonds.     

INCREASING COMMUNICATIVE INTERACTIONS OF YOUNG CHILDREN WITH AUTISM USING A VOICE OUTPUT COMMUNICATION AID AND NATURALISTIC TEACHING

We evaluated the effects of a voice output communication aid (VOCA) and naturalistic teaching procedures on the communicative interactions of young children with autism. A teacher and three assistants were taught to use naturalistic teaching strategies to provide opportunities for VOCA use in the context of regularly occurring classroom routines. Naturalistic teaching procedures and VOCA use were introduced in multiple probe fashion across 4 children and two classroom routines (snack and play). As the procedures were implemented, all children showed increases in communicative interactions using VOCAs. Also, there was no apparent reductive effect of VOCA use within the naturalistic teaching paradigm on other communicative behaviors. Teachers' ratings of children's VOCA communication, as well as ratings of a person unfamiliar with the children, supported the contextual appropriateness of the VOCA. Probes likewise indicated that the children used the VOCAs for a variety of different messages including requests, yes and no responses, statements, and social comments. Results are discussed in regard to the potential benefits of a VOCA when combined with naturalistic teaching procedures. Future research needs are also discussed, focusing on more precise identification of the attributes of VOCA use for children with autism, as well as for their support personnel.     

“Lying” in the pigeon

Two pigeons were taught to use symbols to communicate information about hidden colors to each other. When reporting red was more generously reinforced than reporting yellow or green, both birds passed through a period in which they “lied” by reporting another color as red.     

Cultural Differences in Physical Contact Between Hispanic and Anglo Mother–Infant Dyads Living in the United States

This is a study of differences in physical contact and tactile interpersonal behaviours between Hispanic and Anglo mothers and infants living in the United States. Infants were 9 months old and 52 mother–infant dyads, 26 Hispanic and 26 Anglo, were videotaped during free play without toys in a university laboratory playroom. Coders judged the interpersonal distance, physical contact and affectionate touch from the videotapes and mothers responded to a questionnaire about the importance of physical contact and affectionate touch in their relationship with their infant. From questionnaire data we found that Hispanic and Anglo mothers both touch their infants on a daily basis, although Hispanic mothers report touching more frequently, being more affectionate with their infants and having more skin-to-skin contact. From videotaped observations we found that there were no overall differences in mother–infant touch between the two cultures; however, the Hispanic mothers showed more close touch and more close and affectionate touch compared to Anglo mothers, who showed more distal touch. The results are discussed in terms of the role of touch in infant development and cultural differences in the evaluation of close physical contact and touch.     

Correspondence training, prior verbal training, and control of nonverbal behavior via control of verbal behavior

The role of prior verbal training in correspondence training and later verbal control of nonverbal behavior was examined in two groups of Head Start children. One group received correspondence training without prior verbal training, the other with. Essentially no differences were found between the two sequences; thus it seems appropriate to consider the content phases (reinforcement contingent on target verbalization alone) of previous research as control procedures and not a necessary precursor to correspondence training.     

萨提尔家庭治疗模式评析

萨提尔家庭治疗模式是建立在经验人本理论基础之上的。她认为人类本身具有成长改变的能量,症状行为是对误入歧途的适应性努力,而不是人的固有的个性特征。为此,她逐渐拓展了自我价值、家庭系统的内涵,形成了沟通姿态、转化历程等核心理念,并开发出一系列生动实用的干预技术。萨提尔家庭治疗模式具有独特的优越性。     

How extraverted is honey.bunny77@hotmail.de? Inferring personality from e-mail addresses

Computer mediated communication (CMC) plays a rapidly growing role in our social lives. Within this domain, e-mail addresses represent the thinnest slice of information that people receive from one another. Using 599 e-mail addresses of young adults, their self-reported personality scores and the personality judgments of 100 independent observers, it was shown that personality impressions based solely on e-mail addresses were consensually shared by observers. Moreover, these impressions contained some degree of validity. This was true for neuroticism, openness, agreeableness, conscientiousness, and narcissism but not for extraversion. Level of accuracy was explained using lens model analyses: Lay observers made broad use of perceivable e-mail address features in their personality judgments, features were slightly valid and observers were sensitive to subtle differences in validity between cues. Altogether, even the thinnest slice of CMC—the mere e-mail address—contains valid information about the personality of its owner.