Medical ethics in Norway: Modern medicine — Traditional morality

In Norway, by tradition a Lutheran country, the puritan ethics of a “moral minority” has a strong influence on the development and manifestations of medical ethics. Those who exert this influence are found primarily among politicians, the clergy, and, last but certainly not least, among nurses and doctors. The focus of interest is not so much on problems of bioethical moral theory or the teaching of bioethics to students, but very much on attitudes and policies with regard to substantive issues traditionally regarded in Norway as burning bioethical issues, such as: medical research ethics, abortion, prenatal diagnosis, euthanasia, definitions of death, and reproductive technologies.     

Differential predictability of preferences and choices

A combined multi-attribute utility and expectancy-value model has repeatedly been found to yield a worse fit to choices than to preference ratings. The present study investigated two possible explanations for this finding. First, people's belief-value structures may change in the choice task as they try to find the best alternative. Second, a difficult choice task may cause the decision maker to use simplifying heuristics. In the first of two experiments, subjective belief-value structures were measured on two occasions separated by about one week. Immediately before the second measurement, different groups of subjects performed a choice task, gave preference ratings, or performed a control task. The results did not support an interpretation of the greater difficulty of predicting choices in terms of changes in belief-value structures. However, the notion of simplifying heuristics received support by the finding that adopting simpler versions of the original model improved the predictions of the choices. In the second experiment, beliefs were measured immediately before or after each of a series of choices or preference ratings. The results indicated that although temporary changes in beliefs may occur, they can hardly provide a full account of the differential predictability of preferences and choices.     

A beginner's guide to the problem-oriented first family interview

The large volume and diversity of family therapy resources can often confuse trainees who are in need of more abbreviated guidelines for managing their clinical responsibilities. This paper presents a structured outline of a problem-oriented first family interview for the family therapy supervisor and the beginning family therapist. We view the first interview as an integrated process including the important tasks preceding and following the initial family meeting. After the goals that shape the work of the first interview are described, a step-by-step guide to the twelve phases of the interview is presented: telephoning; forming hypotheses; the greeting; the social phase; identifying the problem; observing family patterns; defining goals; contracting; checklist; revising hypotheses; contacting the referral person; and gathering records. This approach to the first interview integrates a variety of structural and strategic procedures. The guide, intended for use in conjunction with close supervision, may serve as a foundation on which beginning therapists can build their unique styles.     

Reflex responses of human lip muscles to mechanical stimulation during speech

The role played by reflex pathways in the production of movement has been a significant issue for motor control theorists interested in a wide variety of motor behaviors. From studies of locomotion and chewing, it appears that gains in reflex pathways can be altered so that activity in these pathways does not produce destabilizing responses during movement. In speech production, recent experimental evidence has been interpreted to suggest that autogenetic lip reflexes (perioral reflexes) are suppressed during sustained phonation or speech production. The present study was conducted to assess the effects of phonation, direction of movement, and ongoing speech production on reflex responses of lip muscles. The present results suggest, in contrast to earlier work, that this reflex pathway is not suppressed or absent because the amplitude of the observed response depends upon the activation levels of the various muscles of the lower lip and, therefore, indirectly on the nature of the gesture the subject is instructed to produce.     

Infant hypotonia, obesity, hypogenitalism and oligophrenia--new viewpoints on the etiology and symptoms of Prader-Willi syndrome

We present four cases of Prader-Willi syndrome. Two of them have an abnormality of a chromosome 15, the other both show different chromosomal abnormalities. Translocations or deletions were found recently in the bands 15q11/12 in about 60% of the cases of Prader-Willi syndrome. The consequences for diagnosis, symptomatology and genetic counselling of the syndrome are discussed.     

Pupillary responses to syntactic ambiguity of sentences

Pupillary responses have proven to be reliable physiological correlates of cognitive effort in a variety of tasks, including language processing. To investigate the relation between psychological and syntactic complexity 20 syntactically ambiguous sentences, balanced for bias, were presented to 16 subjects, while their pupil size was continuously measured. These sentences could be read as verb oriented (syntactically more complex) or object oriented (syntactically less complex). Principal components analysis of pupillary movements revealed that verb-oriented readings, resulted in greater pupillary dilations than object-oriented readings, indicating that syntactically more complex sentences, as determined via a formal grammar, require greater cognitive effort in processing. This is viewed as further evidence for the notion that syntactic and psychological complexity are related. High- and low-bias sentences did not induce comparable differences in pupillary movements, indicating that the "multiple meaning theory" may have to be modified.     

In-session gaming as a tool in treating adolescent problematic gaming

For some adolescent gamers, playing online games may become problematic, impairing functioning in personal, family, and other life domains. Parental and family factors are known to influence the odds that adolescents may develop problematic gaming (PG), negative parenting and conflictual family dynamics increasing the risk, whereas positive parenting and developmentally supportive family dynamics protecting against PG. This suggests that a treatment for adolescent PG should not only address the gaming behaviors and personal characteristics of the youth, but also the parental and family domains. An established research-supported treatment meeting these requirements is multidimensional family therapy (MDFT), which we adapted for use as adolescent PG treatment. We report here on one adaptation, applying in-session gaming. In-session demonstration of the “problem behavior” is feasible and informative in PG. In the opening stage of therapy, we use in-session gaming to establish an alliance between the therapist and the youth. By inviting them to play games, the therapist demonstrates that they are taken seriously, thus boosting treatment motivation. Later in treatment, gaming is introduced in family sessions, offering useful opportunities to intervene in family members' perspectives and interactional patterns revealed in vivo as the youth plays the game. These sessions can trigger strong emotions and reactions from the parents and youth and give rise to maladaptive transactions between the family members, thus offering ways to facilitate new discussions and experiences of each other. The insights gained from the game demonstration sessions aid the therapeutic process, more so than mere discussion about gaming.