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PubMed2006

The consequences of surrendering a degree of freedom to the participant in a contingency assessment task.

Many studies of contingency judgments have used a task in which, on each trial, the participant is free either to respond or not to respond, and an outcome may, or may not, be presented. Typically, the experimenter specifies a nominal value for the contingency between responding and outcome, but the actual values of a variety of variables experienced by a particular participant depend on that participant's frequency of responding. The results of computer simulations of various strategies for implementing the contingency manipulation, and the results of an experiment, indicate that the same nominal contingency value will lead to considerable variability in the actual contingency experienced by participants. Moreover, nominal contingency manipulations are confounded with the probability that the subject experiences an outcome. While researchers might be aware of these issues, not enough attention has been paid to their potential impact.

Adaptation, Psychological↗
PubMed1998

Primum atrial septal defect in children: early results, risk factors, and freedom from reoperation.

BACKGROUND: Repair of primum atrial septal defect in children usually is associated with a low operative mortality, except for a subgroup of children with congestive heart failure. To determine the early mortality and incidence of reoperation in children with primum atrial septal defect, we analyzed retrospectively the results of patients who underwent repair of this defect. METHODS: Between July 1982 and December 1996, 180 children underwent repair of primum atrial septal defect. The mean age at repair was 4.6 years (median, 3.6 years; range, 1 month to 16.4 years); of the 180 children, 23 were infants less than 1 year of age. Absent or mild symptoms were present in 145 (80%), whereas 34 (20%) of children presented with severe symptoms or congestive heart failure. RESULTS: Early mortality occurred in 3 (1.6%); 2 were less than 1 year of age. Follow-up ranged from 2 months to 14.5 years (mean, 6 +/- 4.2 years). Actuarial survival is 98% at 10 years with no late deaths. Age less than 1 year is a predictor of death. During follow-up, 17 (9%) of the 180 patients underwent reoperation, 5 of whom were in the infant group. Five underwent reoperation for subaortic obstruction, and 12 for left atrioventricular valve regurgitation of whom 11 were repaired; and 1 required valve replacement. Age and preoperative moderate-to-severe left atrioventricular valve regurgitation were predictors of reoperation. CONCLUSIONS: Results of the repair of primum atrial septal defect during childhood are favorable. Infants have a higher risk for death and reoperation. Left atrioventricular valve insufficiency and subaortic stenosis are important late complications and can be repaired safely at reoperation.

Adolescent↗
PubMed1998

Freedom to enjoy learning in the 21st century: developing an active learning culture in nursing.

In 1994, the Wolfson School of Health Sciences was created in Thames Valley University, UK. This paper discusses an active learning approach being implemented throughout the university, and gives an outline of its application within nursing education. Practising as a confident, competent, reflective practitioner in the profession of nursing cannot automatically commence on the day of registration. Rather, the philosophical underpinnings necessary should be fostered throughout the initial nursing education curricula. In a political climate where there is a strong emphasis on efficiency, nurse teachers need to reconsider how the acquisition of nursing knowledge is facilitated. A description of how an active learning approach is being further developed in the nursing skills laboratory and the physiology laboratory is given. An outline identifies how these facilities may help students of nursing to gain knowledge and skills in relation to respiration. The authors recognize that while laboratories have been used widely in general education, their use has been limited in nursing education, particularly in the UK. Informal feedback from students implies that not only do they enjoy learning in these facilities, but also motivation towards learning is raised, an important element in the learning process. It is suggested that this will result ultimately in increased nursing competence. The authors acknowledge that these are preliminary informal findings and that formal investigation is required.

Education, Nursing, Baccalaureate↗
PubMed2006

Procreative tourism and reproductive freedom.

In many societies, the use of assisted reproduction technology has produced a desire to control and regulate this form of treatment. Politicians have taken most decisions. These regulations hold important implications for patients, and there are no two countries with the same regulations. These important differences have led to a traffic of infertile couples across legislative borders to seek a solution to their problem. Would harmonization of laws have positive effects? It seems that it would lead to a minimal common legislation. Procreative tourism is actually a 'safety valve' for many European couples.

Europe↗
PubMed2005

Reproductive freedom and the State.

This brief paper describes the experiences and attitudes of a UK Member of Parliament to the politics of reproductive biomedicine. It provides insights into how problems in this field strike politicians and governments, and their interactions with the press and the public. It takes examples of four topics which help to decide the attitudes of legislators in such complex ethical matters. It also reveals how they can change their opinions as they became familiar with the ethical issues raised under various situations.

Bioethical Issues↗