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PubMed1981

Evaluating summer camps 1979 - problems of measuring behaviour change in children.

To develop experience in assessing behaviour change in children, sixteen children attending week-long summer camps run by the Department of Psychiatry, Adelaide Children's Hospital in January 1979, were assessed every two months for six months. Target complaints, symptom checklists and measures of social behaviour were chosen as being most likely to be sensitive to behaviour change. Hypotheses about the summer camp experience having an influence on severity of target behaviour problems, symptoms indicating child psychiatric disorder, peer group participation, mastery of aggression and development of conscience and social values were not convincingly supported. Agreement between camp staff and parents rating the children's social behaviour using the same instrument a week apart was poor. Simple ranked adjective scales have advantages over goal attainment scaling for rating target complaints, Implications for treatment evaluation in child psychiatry are discussed.

Adolescent↗
PubMed1979

A social-learning approach to student marijuana use.

Three hundred seventy-two college students were administered a battery of questionnaires designed to assess the predictive power of four social variables (social support, perceived sanctions, availability, family models), and six psychological ones (locus of control, mortality-conscience guilt, personal meanings, functions for continuing use, belief in consequences, societal and non-societal means of valued goal attainment) with respect to marijuana use. Results support a social learning theory interpretation of marijuana use. Users have had pleasant experiences, believe that sanctions are minimal, and that marijuana is not harmful. Six predictor variables correlated +.76 with use.

Adolescent↗
PubMedDate not supplied

The present state and problems of "The Code of Medical Ethics" in Japan.

A code of professional ethics for the physician in Japan is being prepared caused by the progress of the medical conditions. The Japan Medical Association (JMA) enacted "the guideline on professional ethics for the physician" in 2004. However, as for the substantial effect of this guideline, it may not be able to be expected. The present state of the professional group of the physician in Japan can be shown as that reason. (1) First, there is not any physician's group of the compulsory admission, but only professional ability profit group of the voluntary admission in Japan. (2) There are not ethical regulations of the profession which has legal effect to face in the physician's misconduct in Japan. (3) In addition, there is not any autonomous organizations inside the professional group which examine and impose disciplinary punishment to the physician who went through misconduct in Japan. After all, the ethics in the physician would be left to each physician's conscience. Then, how should we do to solve such various fundamental problems? In this paper, the situation in various foreign countries is surveyed as an indication of the Japanese medical profession's future conduct. Moreover, I present some solutions to the various problems in fulfilling the professional ethics for the physician in Japan.

Codes of Ethics↗
PubMedDate not supplied

Ethical decision-making in nursing: implications for continuing education.

Staff nurses make ethical decisions daily. It is important that nurses know how to manage those decisions appropriately so that clients' ethical rights are honored without compromising the nurse's own moral conscience. In this phenomenological study, 19 staff nurses described their experiences in making ethical decisions in their practices. The interviews were transcribed and analyzed using Giorgi's phenomenological steps. The description of the nurses' experiences identified two distinct components of the ethical decision-making process: deliberation and integration. The findings suggest that nurses need to: a) recognize the ethical nature of their work, b) discern which ethical decisions are theirs to make, and c) acknowledge their authority to make ethical decisions in their practices. These findings have important implications for the continuing education of nurses regarding ethical decision-making.

Decision Making↗
PubMed2006

[Medical professionalism: historical and religious aspects].

The essence of the medical profession resides in the medical act, whereupon a sick human being meets another with the power to heal him or her. The source of this power has evolved from the divinity itself through magic to science or acquired knowledge. This power implies acknowledgement of values that are inherent to the profession as well as responsibility toward one's own conscience and toward society, elements considered constitutive of what we now call professionalism. From antiquity these principles have evolved into behavioral codes containing variable components according to the different ages and cultures, but also permenent core values such as respect for life, altruism, and honesty, among others. Scientific and technological advances have magnified medical power but at the same time they have required that the philosophical and ethical principles that ought to inform professional practice be made explicit. This happens at a time when certitudes are questioned or abandoned, relativism and secularism pervade culture, and traditional medical values are challenged. Therefore, consensus attainment appears for some as the only legitimation of the ethics of professional medical acts, while for others the ancestral principles and values of medicine have permanent validity as objective goods based on the dignity of the human person.

Codes of Ethics↗
PubMed2005

[Herpetic encephalitis in adults: 23 cases].

OBJECTIVE: To study the clinical presentation, diagnosis, treatment and prognosis of the herpetic encephalitis in our environment. MATERIAL AND METHOD: During the past 12 years, 23 adults (age > 15 years) were treated for herpetic encephalitis in our centre. RESULTS: There were 14 males and 9 females. Ages ranged from 18 to 84 years (mean, 52.30 +/- 18.64 years). The hospital stay ranged from 5 to 64 days (mean, 26.74 +/- 15.41 days). Eleven patients were managed in the intensive care unit and nine patients required mechanical ventilation. The most frequent clinical features they were the level of conscience decrease and fever. The lymphocytic pleiocytosis was the most frequent discovery in cerebrospinal fluid. The temporal lobe lesions in the computed tomography scan appeared in 14 patients (61%). Four patients died, seven patients were asymptomatic or with minimum sequels and twelve patients developed they were disabled. CONCLUSIONS: The herpetic encephalitis is an uncommon illness. Intravenous acyclovir is recommended treatment and the corticosteroids use is controverted. The delay in the treatment beginning worsens the prognosis. Less than a third of the patients achieve the functional independence to discharge hospital.

Adult↗
PubMed2002

[Structure of guilt eliciting situations in Japanese adolescents].

The aim of the present study was to specify guilt eliciting situations for Japanese adolescents, and examine the relationship between guilt-proneness in the situations and personality traits. With an open-ended questionnaire, 315 guilt experiences were collected and categorized into 37 situations. Situational Guilt Inventory (SGI) for the 37 was developed and administered to 500 Japanese adolescents. Factor analysis found four factors: hurting others, inconsiderate to others, acting selfishly, and debt feeling toward others. SGI scores had positive correlations with private and public self-consciousness and depression. However, correlations with the Big Five were low, none higher than .2, except those with conscientiousness. The factors were similar to those of Dimension of Conscience Questionnaire (DCQ; Gore & Harvey, 1995) and Situational Guilt Scale (SGS; Klass, 1987), except that they do not have the fourth: debt feeling. These results showed some characteristics of guilt among Japanese people, as well as reliability of the inventory.

Adolescent↗
PubMed1998

Caring in context: caring practices in a sample of Hong Kong nurses.

In an effort to place the international literature and research in nursing in a Chinese cultural context a study was commenced to examine the caring practices of nurses in Hong Kong. In view of a recent study (Wilkes & Wallis, 1993) which utilised Roach's 5Cs of caring (Roach, 1987, 1992), a pilot study was commenced on a sample of 77 Hong Kong Registered Nurses studying a Diploma of Nursing. An open ended questionnaire was designed which asked nurses to respond to questions about caring in general and the 5Cs: compassion, competence, confidence, conscience and commitment. The questions asked what each of the concepts meant to them as a nurse. Data was analysed into themes based on key words for each of the six areas revealing that the sample of Hong Kong nurses viewed caring in a similar light to those in overseas studies. The sample highlighted compassion and competence as their major features and it is suggested that methodological problems may have inhibited a deeper analysis of their caring attributes and behaviours. When asked to expand on the 5 Cs in terms of their own practice they were able to supply themes which were closely related to Roach's definitions but which may have been more 'textbook' in their origin and certainly lacked a richness of response. The paucity of responses in terms of clarity and richness of data, followed by discussions with the participants led to conclusions about the methodological issues of cross-cultural research and recommendations for future research are made. Highlighted are the problems with attempting to use concepts such as the 5 Cs across cultures and the problems encountered with translation of concepts related to caring from Chinese into English, and vice-versa. The study has provided some insights into the concepts of caring in Hong Kong Chinese nurses. In the light of advances in China and unification of previously separate countries these findings provide and offer insights into nursing in China and are encouraging for future research.

Clinical Competence↗
PubMed1995

Ethical aspects of prevention.

Within the very large area of ethical concerns, the following issues are considered in this paper: (i) intellectual and career-oriented ambition, combined with the pressure that the competition for funds exerts, may push certain scientists to make dubious compromises with their conscience; (ii) exaggerated priority is sometimes given to the smooth running of a trial, even at the cost of ignoring some ethical requirements; (iii) it is questionable whether preventive intervention can adequately and systematically replace primary prevention based on the cessation of exposure to carcinogens; (iv) it is of the utmost importance to ensure that preventive treatment that is to be administered for long periods has no adverse effects or that the benefits by far outweigh the possible risks; (v) the informed consent of participants to the trials is essential and it should be obtained on the basis of correct, complete and clear information; (vi) a different type of informed consent is that of all citizens with regard to risks to which they may be exposed voluntarily or involuntarily; (vii) there is no justification for, and it is profoundly unethical to omit, delay, or hide information that may be relevant to the protection of health. Four examples were chosen to illustrate the preceding points.

Anticarcinogenic Agents↗
PubMed2006

[Taking the responsibility of a 'knowledge' one only has access during mental health consultations: stakes of an ethical issue].

Everyone has a certain knowledge of what psychologically constitutes him/her. Part of the therapist's ethical approach is to help this knowledge come to conscience. Apart from the analytical process, within one or a few therapeutic sessions, is the person consulting able to have access to a minimal knowledge about him-herself? Using this knowledge to guide certain aspects of his-her life, calls upon an ethics of responsibility on the part of the person consulting. To have this knowledge emerge demands on the therapists' part, a concept of the human being that takes into account subjective dimensions of the person.

Adaptation, Psychological↗
PubMedDate not supplied

Abortifacient drugs: ethico-legal issues.

It is conceivable that an oral medicine capable of terminating pregnancy will become available for use in this country. Such a drug will pose significant moral and legal dilemmas for nurses who may find themselves embroiled in situations where they are uncertain of how to reconcile their consciences with statutory law and the requirements of their employers. The RCN Ethics and Nursing Committee offer some guidance on how nurses should act under such difficult circumstances.

Abortifacient Agents↗
PubMedDate not supplied

Accountability in delivering care.

In the penultimate part of this series on issues in ward management facing charge nurses. George Castledine concentrates on the issue of accountability. The immensely powerful position of the charge nurse as arbitrator and co-ordinator of all health care given to the patient demands that helshe exercises this power responsibly and positively; hence, the crucial importance of accountability. The author explores this concept and also those of advocacy and conscientious objection. He concludes by suggesting that the ultimate area of accountability in nursing is the individual conscience of the practitioner and that in this may lie the key to the setting and maintenance of high standards of care.

Humans↗
PubMed1999

[Reduced passive smoking exposure of children--parental behavior, possibilities for change and determinants].

So far there have been hardly any investigations as to under what conditions parents can avoid or reduce their children's exposure to passive smoking similarly, there has not been much investigation on physician's influence on parental behaviour. In an anonymous questionnaire given to 105 parents (only one parent), one half of the children were constantly exposed to smoke. In households with both parents smoking a very high level of exposure is to be expected due to behaviour and cigarette-consumption. The problem is aggravated by visitors and partners who also smoke. A lack of parents' awareness of passive smoking cannot be regarded as relevant. The main thing that puts a stop to changing this seems to be taking a decision and is also dependent on the amount of cigarette smoke. Only 46% of the participants reported to have been addressed by their physician on this subject. No negative reactions to this intervention on behalf of the physicians were reported in this survey. Instead, talking about it rather made the patient feel he had a bad conscience. Hence, the doctors' concern about a negative reaction does not seem to be justified. Structured intervention strategies which can be introduced in hospitals or in a physician's general practice should be developed and tested.

Adolescent↗
PubMed1990

Whistleblowing and the security director: an update.

Whistleblowers often find the path of conscience leads to the unemployment line. But, once fired, many also wear a path to the courthouse seeking damages. Recent cases involving hospitals and other employers are defining the risks for both employees and hospitals when someone blows the whistle. This report will outline some of those cases, provide tips from experts, and review state and proposed federal legislation aimed at protecting the rights of whistleblowers.

Employee Grievances↗
PubMedDate not supplied

Emerging leaders 1991. Six who have arrived.

"I would quibble with the idea that Cheryl is an 'emerging leader,"' observes a colleague of one of this year's honorees. "I believe she has arrived." In truth, each of the six extraordinary people cited as 1991's Emerging Leaders have had a major impact on their organizations and, by example and design, on the nature and quality of healthcare in their communities. But then, the annual call for nominations demands nothing less. Sponsors Korn/Ferry International and The Healthcare Forum are "looking for...talented people with the proven ability to nurture the growth of the industry. They are dynamic, decisive young leaders who have already made a mark." Five men and one woman, all age 40 or younger, were selected as this year's Emerging Leaders in two separate categories. Three represent large healthcare organizations, three smaller urban or rural institutions--generally hospitals with fewer than 200 beds. Interestingly, nearly all were influenced to pursue careers in healthcare at an early age. Two had physician parents, two were sons of healthcare administrators, two worked in hospitals as teenagers. All, of course, have shown their mettle in difficult times and complex, uncomfortable situations. All have been pivotal in turning around failing--or at least beleaguered--organizations. Yet, while each has labored diligently to further the interests of his or her own organization and constituency, each has also sought to shape a more cooperative system. As honoree Larry Sanders observes, "Competition without conscience will deny our claim to a true community leadership role." Marveling at the accomplishments of honoree Kevin Fickenscher, an awed peer declared: "One of these days we'll all be working for him!"(ABSTRACT TRUNCATED AT 250 WORDS)

Awards and Prizes↗
PubMed1976

[Affective perception of the body in neurotics. Its relation to anxiety, depression, and various types of defense].

This study compares and relates affective bodily perception (ABP), anxiety, depression, and the utilisation of some defense mechanisms in 25 neurotic women (16 depressives, 9 hysterical) and 25 normal women. ABP is evaluated according to satisfaction and anxiety (Body cathexis scale), distorsions (Body distortion questionnaire) and body conscience (Body prominence). Anxiety is measured with Cattell questionnaire, depression through Zung and Hamilton scales, and defense mechanisms by the Firo Form Cope of Schutz. Neurotics have a ABP more negative and are more depressed and anxious than normals; they use more regression while controls tend to use introjection. In comparison with depressives, hysterical women have higher scores in body distortion, mostly in the feeling of boundary loss; they express more masked anxiety and react more often through projection. Among neurotics, those who have a very disturbed ABP are more anxious, more depressed, and more prone to denial, projection, and regression in comparison with the others. In both samples, anxiety and depression have a negative correlation with body satisfaction and a positive one with body distortions and somatic anxiety. In the control group, body satisfaction is inversely related with feeling of dirt. Somatic anxiety is also inversely related to unusual feelings of body and skin obstruction. The intensity of body consciousness is related to using isolation and distortions are negatively related to using denial. In neurotics, denial is in opposition with the intensity of body awareness and is linked to somatic anxiety. The intensity of body awareness is also correlated to various forms of anxiety. Distortions are positively related to regression. The comparison of both samples shows a degradation of ABP in neurotics. The study of correlations clarifies several relations between deficient ABP anxiety, depression and the use of some defense mechanisms.

Adult↗
PubMed1985

Max Weber or Jesus Christ: in whose image?

The bureaucratic model of organization and the model that emerges from the Gospel and Vatican Council II provide a stark contrast for Catholic health care administrators to ponder. As articulated by sociologist Max Weber, a bureaucracy is based on a hierarchical structure with sharply defined and protected levels of authority, centralized decision making, rules that govern personnel behavior, and an impersonalized view of employees that stresses their roles as functionaries. The Christian, Gospel-based model, on the other hand, places a premium on collegiality, shared authority, the mediation of conscience, the common good, and the work of the individual. Even though only a few will shape management policy in a large hospital, policymaking should be viewed as a service, a ministry that entails stewardship. Catholic health care leaders should reflect the spirit of collegiality by bringing various strata of staff together in a dynamic, united effort. Thus the institution's statement of mission will not be an abstract recitation of pieties but a living reality, a philosophy that is "owned" by the workers.

Christianity↗
PubMedDate not supplied

[Statistical and epidemiological on the incidence of salmonellosis in Valdinievole's district (author's transl)].

The Author, on the basis of the data of his Laboratory in Pescia's Hospital, put in evidence the diffusion of the endemic state due to Salmonella in his district and calls competent authority's attention for a greater conscience of this problem, so as to embank a situation that, controlled efficaciously, could cause epidemical episodes like those happened in other zones of our Country.

Feces↗