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PubMedDate not supplied

Population policy forum. Women as subjects, not objects.

I very much agree with Marge Berer that feminists must recognize that there needs to be a population policy, worldwide and country by country, that encourages lower birth rates and that it is essential to start talking about population policies that respect and promote women's moral agency. Indeed I think it would be fair to say that the failure to respect and promote women's moral agency is the major reason why government-sponsored population policies have failed in the past. Male population planners habitually think of mass population as objects, rather than subjects, of population policy. This is why they think so readily of "incentives" or even more coercive methods. Birth control is thought of as a "war" to be imposed on the population, not as an integral part of the self-development of the people's own capacity to organize and become decisionmakers. If this is true in relation to the male population, it is even more so in relation to women. Population policy continues the basic male approach to women as bodies under their control, not as self-actualizing subjects. Until population policies take as their starting point women's human development as persons and moral agents in their own right, such policies both will be abusive to women and also will not "work." However, Marge Berer's remarks about oppressive, dehumanizing governments as incapable of promoting any other form of population policy give one pause. If this is the case, then neither national governments nor most international agencies linked to Western hegemonic neocolonialism can be the authentic promoters of feminist population policy. There must be a global effort to build parallel women's health organizations that work on the grassroots level with women, especially poor women, to empower these women themselves to become the leaders in educational and economic development of the women in their communities. Only in and through this larger context can such women both learn how to use and become empowered to use methods of birth control.

Behavior↗
PubMed2006

Strategies for the prevention and control of osteoporosis in developing countries.

The frequency of osteoporosis and fragility fractures has been studied to a very limited extent in few developing countries. The aim of this paper is to review briefly the burden of osteoporosis and fragility fractures in these countries and to propose some strategies for the prevention and control of those conditions, considering barriers and facilitators for their implementation. The evolution of the demographic composition in most regions with developing countries shows a considerable increase in life expectancy and therefore, a significant growth in elderly population can be expected. Reports on the incidence of fragility fractures show figures in many of those countries that are comparable to those found in developed nations. Health resources (for acute treatment of fractures, their rehabilitation and chronic management, for diagnostic centers and drug therapy for osteoporosis) are limited in most of those regions and are allocated to other health priorities. Internationally accepted guidelines can be adapted to the realities of developing nations and may be promoted by organizations of health professionals and patients, but require endorsement and support by health authorities. The steps should include: (a) campaigns to increase awareness, both among the population at risk and relevant health workers; (b) the promotion of a preventive lifestyle in the general population; (c) the development of national or regional, evidence-based guidelines for the diagnosis and treatment of osteoporosis; (d) development and implementation of guidelines for the treatment of fragility fractures, their rehabilitation and prevention of falls; (e) collection of economic data on fractures and osteoporosis; and (f) development of country-specific fracture databases. These steps may help in reducing the increasing burden of osteoporotic fractures. Their implementation will require solid scientific basis and commitment from policy makers, health professionals, patient organizations, and ultimately the general population.

Developing Countries↗
PubMed2004

Bioethics as a scientific enterprise.

The authors of this article attempt to look at the manner in which the field of bioethics has emerged to represent an entirely new science. The article does this by first looking at various developments in the field of medicine and science. Specifically, the authors point to the developments in pharmacology, biology, and in genetics, as the stimuli for the field of bioethics. Since these three fields of study directly deal with human beings and their respective environment, new developments in these respective areas of science have questioned what society has traditionally held concerning these two concepts. In an effort to help answer such questions, the field of bioethics has emerged. The authors argue that bioethics represents more than just a theoretical field. Instead, bioethics, as an entirely new science in itself, has the ability to provide answers to the question, and moral dilemmas that new developments in other sciences raise. The article attempts to show that science/medicine has direct links to proper therapy and procedures. The authors do this by making a direct connection between ethics and medicine, as Hippocrates understood. For Hippocrates, medicine and science should be distinguished from religion, but not from proper ethos. Therefore, the authors argue that the field of bioethics has gained its status as a scientific enterprise since it provides the ability for scientists and physicians to conduct their work in an ethos that aims to protect the human person.

Bioethics↗
PubMed1992

Germ-line gene therapy and the medical imperative.

Somatic cell gene therapy has yielded promising results. If germ cell gene therapy can be developed, the promise is even greater: hundreds of genetic diseases might be virtually eliminated. But some claim the procedure is morally unacceptable. We thoroughly and sympathetically examine several possible reasons for this claim but find them inadequate. There is no moral reason, then, not to develop and employ germ-line gene therapy. Taking the offensive, we argue next that medicine has a prima facie moral obligation to do so.

Embryo, Mammalian↗
PubMed1994

Maternal reports of conscience development and temperament in young children.

Multiple manifestations of emerging conscience, their development, organization, and links with temperament were studied in 171 21-70-month-old children. A new parental report instrument was designed to measure conscience, with good psychometric qualities and predictive of children's behaviors in a laboratory. For most aspects of conscience, the major developmental shifts occurred around age 3.2 components of early conscience emerged in factor analyses: Affective Discomfort, significantly higher for girls, that encompassed guilt, apology, concern about good feelings with the parent following wrongdoing, and empathy with others, and Active Moral Regulation/Vigilance, which included confession and reparation following wrongdoing, internalization of rules of conduct (self-regulation), and concern about others' wrongdoing. Children's temperament, assessed by maternal reports, was associated with conscience. Low impulsivity and high inhibitory control were associated with Active Moral Regulation/Vigilance for both sexes and, for girls only, also with Affective Discomfort. For girls, temperamental reactivity related positively to Affective Discomfort and negatively to Active Moral Regulation/Vigilance.

Affect↗
PubMed1998

The nurse executive role in Hong Kong's transforming healthcare environment.

The goal of International Perspectives is to share the views of nurse leaders, from countries other than the United States, on global healthcare issues. The focus is on identifying healthcare management problems and their implications, research priorities, policy development, and ethical-moral dilemmas faced by nurse administrators. You are encouraged to send the names and addresses of international nurse leaders who might be interested in participating, as well as your ideas, for format and content of the department.

Education, Nursing, Continuing↗
PubMed2005

Nurses' satisfaction with their work environment and the outcomes of clinical nursing supervision on nurses' experiences of well-being -- a Norwegian study.

BACKGROUND: Various studies have demonstrated that nursing is stressful and that the incidence of occupational stress-related burnout in the profession is high. AIM: This descriptive-correlational study examined nurses' satisfaction with their psychosocial work environment, their moral sensitivity and differences in outcomes of clinical nursing supervision in relation to nurses' well-being by systematically comparing supervised and unsupervised nurses. METHODS: Nurses were selected from two hospitals (n = 71). Data collection was by means of questionnaires and analysed by descriptive and inferential statistics. RESULTS: The nurses' satisfaction with their psychosocial work environment was reflected in six factors: 'job stress and anxiety', 'relationship with colleagues', 'collaboration and good communication', 'job motivation', 'work demands' and 'professional development'. The nurses' perceptions of moral sensitivity comprised seven factors: 'grounds for actions', 'ethical conflicts', 'values in care', 'independence patient-oriented care', 'the desire to provide high-quality care' and 'the desire to provide high-quality care creates ethical dilemmas'. Nurses well-being were reflected in four factors 'physical symptom and anxiety', 'feelings of not being in control', 'engagement and motivation' and 'eye strain sleep disturbance'. The moral sensitivity 'ethical conflicts' were found to have mild negative correlations with psychosocial work environment 'job stress and anxiety professional development' and with 'total score' psychosocial work, moral sensitivity factor 'independence were correlated with psychosocial work factor 'relationships with colleagues' and 'total score', moral sensitivity were mildly correlated with 'collaboration and good communication and had a negative correlation to psychosocial work factor 'work demands'. In addition, significant correlations were found between the nurses' well-being profile and demographic variables, between 'engagement and motivation' and 'absence due to illness' and between 'time allocation for tasks', 'physical symptoms and anxiety' and 'age'. Mild significant differences were found between nurses attending and not attending group supervision and between 'physical symptoms and anxiety' and 'feelings of not being in control'. CONCLUSIONS: We conclude that ethical conflicts in nursing are a source of job-related stress and anxiety. The outcome of supporting nurses by clinical nursing supervision may have a positive influence on their perceptions of well-being. clinical nursing supervision have a positive effect on nurses physical symptoms and their feeling of anxiety as well as having a sense of being in control of the situation. We also conclude that psychosocial work have an influence on nurses experience of having or not having control and their engagement and motivation.

Adult↗
PubMed1991

Conceptualization of conscience in normal children and adolescents, ages 5 to 17.

In order to determine how normal children and adolescents conceptualize their conscience, the Stilwell Conscience Interview was given to 125 normal subjects between the ages of 5 and 17. Responses to questions 1, 2 and 11 (including the drawing of conscience) were empirically analyzed, resulting in a five-stage developmental model. The responses were then randomly presented to two blinded raters to assign them to one of the five stages. Highly acceptable interrater reliability was found, Kappa = 0.90. The relationship of age to stage demonstrated a highly significant positive correlation, indicating that the conceptualization of conscience in normal development follows an invariant, hierarchical pattern of organization. A commentary regarding each stage is presented. The value of this conceptualization model as a comparative standard of normality in the clinical assessment of youngsters suffering from psychopathology is discussed relative to assessment, psychotherapy, and future research.

Adolescent↗
PubMed1991

[The finite and infinite development. II. Recent psychoanalytic theory and therapeutic considerations].

Freud's characterization of the manifest dream is typified by an implicit appreciation and an explicit devaluation of dream images. According to the author, the theoretical-historical motive behind this divergent evaluation is already evident in Freud's prepsychoanalytic writings, where he assigns primacy to the written word. The author holds that the biographic motive derives from an ambivalent internalization of the Mosaic sanction against graven images, conveyed to Freud by his father through the spirit of the Phillipson Bible.

Freudian Theory↗
PubMed1997

Adolescent females "voice" changes can signal difficulties for teachers and administrators.

This article describes the different preferences in learning styles of adolescent females and males, based on the pioneering work on adolescent values development by Lawrence Kohlberg and Carol Gilligan. Since values education programs are currently considered very important, educators need to explore the philosophical, psychological, and social influences on students' learning preferences before they can introduce appropriate curricula. An indication of problems in adolescent females frequently is the occurrence of voice changes, for example, girls may express viewpoints that do not represent their true beliefs and feelings. Curricular and co-curricular suggestions are presented.

Adolescent↗
PubMed1989

Shame as an impetus to the creation of conscience.

Shame 'absorbed by' guilt is an issue that was flagged for consideration by Erikson. The most compelling reason for using guilt to obscure shame is that guilt is associated with a sense of the self as strong, though burdened and culpable, whereas shame brings with it a painful sense of vulnerability. Erikson described the way in which compulsive ordering-about of the self allows a child to feel less helpless and less vulnerable to the shame affect. In instituting this type of self-directive behaviour, the child is developing conscience. The irony of this type of self-manipulation is that ultimately the child, or adult, finds himself again burdened by impotence, though it is the impotence of guilt rather than that of shame. The topic of shame yielding to guilt is of interest in part because it demonstrates the highly interactive relationship between narcissistic concerns and superego responses to impulse-expression, and the role of such interactions in the formation of psychological structures.

Adolescent↗
PubMed2005

Of souls, selves, and cerebrums: a reply to Himma.

Ken Himma argues that a human being becomes a moral person at the commencement of brain activity. In response to Himma, the author offers (1) brief comments on Himma's project, (2) an alternative account of the human person that maintains that a human being is a human person by nature as long as it exists, and (3) a counterexample to Himma's position that shows it cannot account for the wrongness of the purposeful creation of anencephalic-like children. The author concludes with replies to two challenges to his position.

Abortion, Induced↗
PubMed1997

Nursing ethics into the next millennium: a context-sensitive approach for nursing ethics.

The aim of this article is to argue for the need for a context-sensitive approach to the understanding of ethical issues in nursing practice as we face the next millennium. This approach means that the idea of universalism must be questioned because ethics is an interpersonal activity, set in a specific context. This view is based on issues that arise in international collaborative research as well as in research focused on ethical problems in nursing practice. Moral values are indigenous to a particular culture and influence beliefs about health and illness as well as what priorities are to be made in providing health care. Nursing practice must include thoughtful reflection on the meaning of moral concepts and principles in terms of culture. Theoretical developments in nursing ethics must be based on empirical research focusing on contextual aspects of health care.

Cultural Diversity↗
PubMed1989

[The superego or conscience. On the difference between the 2 concepts and its significance for psychotherapy of children and adolescents].

Proceeding from the matter-of-fact equation of conscience to superego in recent psychoanalytical papers the author first describes the phenomenon of conscience which is subdivided in manifestations attributed to the good and the bad conscience. By means of the Freudian conception developing from egoideal via idealego to superego Freud's reception of conscience is examined. In this connection the author demonstrates an obvious onesidedness in Freud's use of the term of conscience which leans towards the accusing, punishing, bad conscience. Among Freud's successors, on the part of the psychology of the proprium, heed is paid to those aspects of conscience neglected by Freud, the implicit total aspect of the phenomenon of conscience, however, was lost. Finally the author discusses the double aspect of conscience, the good and the bad conscience, with respect to its impact on the psychotherapy of children and adolescents.

Adolescent↗
PubMed2005

Riding the emotional roller-coaster: a framework for improving nursing morale.

PURPOSE: To examine the literature on employee morale and to construct a model of this area pertaining to nurses. This framework seeks to present morale in a holistic manner, illustrating the causal factors that influence nursing morale, the changes that occur in morale when these input variables are altered, and the consequences to patient care and individual and group nursing practices. DESIGN/METHODOLOGY/APPROACH: A number of published works on morale, its causal factors and resulting consequences are critiqued. The findings from this literature review are used to develop a framework for nursing morale. FINDINGS: The paper presents a definition of morale and, from the literature review, concludes that previous models on morale are fragmented; only tending to explore the variables that influence the employees' emotional state. Consequently, a framework of nursing morale is constructed in order to illustrate this topic from a holistic point-of-view. PRACTICAL IMPLICATIONS: The paper concludes with a number of management and research implications. The management implications consist of a number of useful suggestions for senior nurses to enhance the morale within their units. ORIGINALITY/VALUE: This paper fulfils an identified gap in the literature, namely the lack of a holistic model of nursing morale, and offers practical help to senior nurses so that they can initiate processes within their wards that can improve their subordinates' morale.

Emotions↗
PubMed1994

[Nurses' ethical development].

The ethical development of a nurse by choices on different levels is discussed in this article. The article is based on the descriptions of 17 nurses. The first important is the choice of a profession. The ethically positive or negative experiences received as a nurse student make their effect on the second choice. The third one occurs on the level where a professional nurse makes his/her own decisions in which it could be necessary to work against the traditional working models. The fourth choice reinforces the former one on situations where the nurse in a goal-directed way enhances his/her readiness to work by fulfilling the values of nursing. In this process independence, courage and expert knowledge are emphasized.

Choice Behavior↗
PubMed1997

The development of forgiveness in the context of adolescent friendship conflict in Korea.

A developmental pattern of understanding interpersonal forgiveness is proposed and examined with 30 junior high and 30 college students in Seoul, Korea. Three questions are asked: Does the developmental sequence in understanding forgiveness relate to age? Is there a relation between the understanding of forgiveness and the degree of forgiveness offered to one's offending friend? Is there a relation between the way people understand forgiveness and how they go about restoring an actual friendship in conflict? All participants had serious and unfair conflicts with their close friends during the past 5 to 6 months. Results support a developmental sequence in Korea and the observed relation between the sequence and actual friendship restoration strategies. There was at least partial statistical support for the relation between understanding forgiveness and the participants' forgiving behaviour in real life situations. Implications are drawn for the study and implementation of forgiveness in adolescents.

Adolescent↗