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At least 145 records · Page 8Linked to original sources
PubMed2006

Service-learning, personal development, and social commitment: a case study of university students in Hong Kong.

Service-learning, which combines academic study with community service, is becoming increasingly popular throughout the world. It is ideally suited to achieving both the personal and academic goals of students and the broader goals of civic responsibility and social justice. This paper describes the design of a local service-learning program the author implemented at a university in Hong Kong. Based on survey data collected from 93 university student participants in the program, it illustrates the impact of service-learning on student outcomes. Results show that the majority of the students benefitted as follows: (1) By developing personal autonomy through real world experiences, students develop a recognition of and faith in their potential. It enhances self-assurance, assumption of new responsibilities, and achievement of individual growth. (2) Students move toward becoming responsible citizens and agents of social change. By learning to care for deprived groups in the community, they are assuming meaningful roles and responding to real issues in ways that have a long-lasting impact on their own lives. Recommendations, based on the shortcomings we have witnessed and the changes we have implemented, are also made.

Achievement↗
PubMedDate not supplied

[Territorial experiment: inter-relational evolution of a group of inmates in the course of an extra-institutional working experiment].

The Authors analize the interrelational evolution of a group of inmates during an outside working activity, with relation to the resocializing experiences which consider the insertion in the area of individuals subjected to detentive security measures. Such evolution, in relation with the influences of the social enviornment one was associated with, was associated with, was marked by an initial cohesion stage between members (of defensive significance), followed by a gradual research of a personal autonomy, in parallel with the acquisition of a reassuring and stabilized role. The utilization of a social space according to the conventional parameters used in the area (with particular concern towards syndical dynamics and rules), reached at the cost of self-exposure, has confirmed the reached maturity and the self balance in proposing themselves to the others as subjects active in their own resocialization, sharing the acquired social rights. Beside the situation concerning the side of the group in its insertion progress, the Authors take into examination the side of the free community in tis receptivity and availability towards the group members, analizing the interactions with the environment as therapeutical moment.

Humans↗
PubMed2006

Reading skills and phonological awareness acquisition in Down syndrome.

BACKGROUND: Although reading abilities play a fundamental role in the acquisition of personal autonomy, up until now studies investigating these abilities in Down syndrome (DS) are aimed at defining educational or rehabilitation acquisition. However, studies describing the relationship between reading and phonological awareness in individuals with DS by comparing them to typically developing children often report contradictory results. The aim of this study is to explore reading and phonological awareness skills in a group of participants with DS. METHODS: We administered reading and phonological processing ability tests to 17 DS individuals and to 17 reading-age-matched typically developing children. RESULTS: Concerning reading abilities, participants with DS were impaired on non-word reading and on interpreting accuracy of non-homographic homophones. Their passage comprehension was also limited. Comparable ability was reported in the two groups on irregular word reading and passage reading tasks. Regarding phonological awareness ability, individuals with DS showed lower performances on several tasks, such as rhyming, deletion and syllable segmentation. CONCLUSIONS: People with DS show particular failure on non-word reading, a task where correct decoding is only partially influenced by lexical access or semantic context. Correct non-word reading mainly requires the use of the grapheme-phoneme conversion process. This process is based on the efficiency of phonological awareness abilities, which are partly impaired in people with DS. The rehabilitative implications of these findings are discussed.

Adolescent↗
PubMed1997

Research with cognitively impaired subjects. Unfinished business in the regulation of human research.

In 1978, the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research issued an important report that addressed the difficult ethical issues arising in research involving subjects with mental disabilities. However, because of irreconcilable conflicts between the scientific community and rights-oriented advocacy groups, the federal government never issued the special regulations pertaining to these issues that had been envisioned by the National Commission. Because these important ethical issues have not yet been adequately addressed by policy-making bodies, protection of cognitively impaired subjects depends too heavily on the diverse ethical sensitivities of individual investigators and on ad hoc responses of particular institutional review boards. Researchers should support a credible and authoritative process for reexamining and resolving ethical issues relating to research with cognitively impaired subjects. This can be accomplished without leading to the stalemate that doomed the National Commission's proposals. The challenge is to forge a consensus on ethical guidelines and safeguards that will most reasonably accommodate the goals of protecting the dignity and well-being of research subjects while avoiding undue impediments to valuable scientific inquiry.

Advisory Committees↗
PubMed1997

Protecting subjects and fostering research. Striking the proper balance.

Bonnie reminds us of the heritage and limitations of human subjects research. He points out that over the years, the protection of human subjects in research has enjoyed progress, experienced false starts, and endured inflated expectations. Both he and Elliott call attention to the fact that IRB review rarely probes how researchers propose to deal with impairments to subjects' decision-making capacities. We agree to IRBs should be encouraged to rethink their roles. But, as Bonnie argues, this requires a systematic review of the roles and functions of IRB rather than ad hoc adjustments by individual institutional IRBs. His proposal that IRBs should be encouraged to be more vigilant and through in their monitoring of research is sound, especially if the subjects are vulnerable or the research is risky. A strength of Bonnie's review is that it suggests both specific ways to test competency and a range of options for IRBs to ensure that vulnerable subjects are protected from overzealous or overreaching researchers. His historical review and normative proposals are objective, balanced, and thoughtful. Elliott's critique seems to single out psychiatric research with depressed patients as a special problem area. Although his title emphasizes severely depressed patients, he sometimes appears to neglect the fact that depression ranges across a spectrum from mild to severe. Elliott's point is well taken that severely depressed patients who are clearly incompetent should not, unless proper safeguards are provided, be enrolled in research. But his analysis falters because his position does not in the end respect personal autonomy.

Depressive Disorder↗
PubMed1997

Deciding life and death in the courtroom. From Quinlan to Cruzan, Glucksberg, and Vacco--a brief history and analysis of constitutional protection of the 'right to die'.

This article analyzes judicial determinations on the "right to die" from Quinlan to Cruzan, Glucksberg, and Vacco. The body of law known as right-to-die cases extends ordinary treatment refusal doctrine to end-of-life decisions. The courts, having affirmed a right to refuse life-sustaining treatment, held that certain categorical distinctions that had been drawn lacked a rational basis. No rational distinction could be made between competent vs incompetent patients, withholding vs withdrawing treatment, and ordinary vs extraordinary treatment. The courts, however, had persistently affirmed one categorical distinction: between withdrawing life-sustaining treament on the one hand and active euthanasia or physician-assisted dying on the other. In Washington v Glucksberg and Vacco v Quill, the Supreme Court unanimously held that physician-assisted suicide is not a fundamental liberty interest protected by the Constitution. Notably, five members of the Court wrote or joined in concurring opinions that took a more liberal view. The Court powerfully approved aggressive palliation of pain. The Supreme Court, hinting that it would find state legalization of physician-assisted suicide constitutional, invited the nation to pursue an earnest debate on physician assistance in the dying process.

Double Effect Principle↗
PubMed2000

Public health law in a new century: part III: public health regulation: A systematic evaluation.

Public health interventions need justification because they intrude on individual rights and incur economic costs. Coercive interventions can be justified in only 3 cases: to avert a risk of serious harm to other persons, to protect the welfare of incompetent persons, and, most controversially, to prevent a risk to the person himself/herself. This article proposes a systematic evaluation of public health regulation. The article recommends that public health authorities should bear the burden of justification and, therefore, should demonstrate (1) a significant risk based on scientific evidence; (2) the intervention's effectiveness by showing a reasonable fit between means and ends; (3) that economic costs are reasonable; (4) that human rights burdens are reasonable; and (5) that benefits, costs, and burdens are fairly distributed. The 3 articles in this series have sought to provide a fuller understanding of the varied ways in which law can advance the public's health. Public health law should be seen broadly as the government's power and responsibility to ensure the conditions for the population's health. As such, public health law has transcending importance in how we think about government, politics, and policy. JAMA. 2000.

Cost of Illness↗
PubMed2000

Cognitive therapy: looking backward, looking forward.

This article reviews some of the historical factors associated with the unprecedented strength and popularity of cognitive therapy, and offers predictions for the next half-century of this approach to treatment. It is predicted that the future will bring with it increased demands on cognitive therapy for evaluation of processes of change (including identification of therapeutic specifics and nonspecifics, technical specification of the process of therapy, and examination of therapist and patient predictors of change), and accountability and efficiency in the public and private sectors. With the increase in personal autonomy, globalization, and technology, the demands from the general public also will increase. One possible risk of the trend towards increased technology is that cognitive therapy may become overly technical. Although specific therapy techniques are crucial to delivering effective treatment, it is also the "nonspecifics" of therapy that add to the "art" of psychotherapy. The final challenge of cognitive therapy also may be the most difficult--to continue to be an empirically based science while maintaining its role in the art of healing.

Cognitive Behavioral Therapy↗
PubMed2007

Depressive symptoms in the very old living alone: prevalence, incidence and risk factors.

BACKGROUND: Living alone is one of many risk factors associated with depression. This project is nested within the ENABLE-AGE project designed to explore the relationship between housing environment and health in the very old living alone in their own homes. AIM: Our aim is to describe the prevalence, incidence and associated risk factors of clinically significant depressive symptoms in this population with particular emphasis on the role of the home environment. METHOD: We conducted a one year follow up of 376 subjects aged between 80 and 90 years old. Data collected included variables concerned with housing, social circumstances, physical health and psychological well being. RESULTS: A prevalence rate of 21% and an annual incidence of 12.4% (Geriatric Depression Score of five or more) were found. Risk factors associated with prevalence depression include not living close to friends and family ((OR 2.540, CI; 1.442, 4.466), poor satisfaction with living accommodation (OR; 0.840, CI; 0.735, 0.961) and poor satisfaction with finances (OR; 0.841, CI; 0.735, 0.961). Subsequent development of clinically significant depressive symptoms was associated with base line increased scores in depression (OR; 1.68, CI; 1.206, 2.341). CONCLUSIONS: These results are consistent with findings in the general population of similar age with the exception of considerably higher prevalence and incidence rates. However, we were unable to demonstrate that housing related variables were significant risk factors in terms of incidence cases. CLINICAL IMPLICATIONS: Older people living alone are particularly vulnerable to depression and may benefit from targeted screening and development of appropriate care pathways.

Activities of Daily Living↗
PubMed2005

Relationships between patients' pre-treatment expectations of toxicities and post chemotherapy experiences.

A lack of adequate pharmacological explanations for side effect variation following chemotherapy suggests psychological factors may contribute to toxicity experience. This research aimed to determine if patients' expectations were associated with perceived toxicities for a wider range of chemotherapy toxicities than previously researched, including subjective and objective side effects. Eighty-seven chemotherapy-naive patients rated their expectations of 20 common side-effects before treatment, and then rated their experiences following their first chemotherapy dose. Hierarchical multiple regression analyses revealed that expectations of the inability to concentrate, hair loss, and diarrhoea prior to treatment had the strongest associations with the experience of symptoms. Expectations of encountering problems with sleep and sex, changes in taste or appetite, weakness, and nervousness, all showed moderate associations, and expectations of mood changes, feelings of tiredness, and nausea all showed weak associations with experience. These outcomes suggest that subjective side effects may be more prone to influence by expectation given their ambiguous nature. However, further research needs to be conducted into the effect expectations have on the treatment process, including the impact of other psychological factors. The current overriding emphasis placed on personal autonomy and fully informed consent may set up negative expectations which translate into adverse experiences to the detriment of the patient.

Adult↗
PubMed2000

The determinants of health care seeking behaviour of adolescents attending STD clinics in South Africa.

The study investigated the determinants of delay behaviour in health care seeking in a sample of 292 adolescent patients (20 years and younger) with STD symptoms. Fifty six percent (56%) of the adolescents sought health care within the first 6 days of noticing symptoms, 23% waited between 7 to 10 days and 21% waited longer than 10 days before seeking health care. Early health care seeking was determined by perceived seriousness of STDs, an absence of self treatment prior to seeking care and positive attitudes regarding personal autonomy in condom use behaviour. Facilitation of early health care seeking remain critical in curbing the threat of AIDS among the South African youth.

Adolescent↗
PubMed1997

Epidemiology of psychiatric care of patients with severe mental disorders in Italy. Rationale and design of a prospective study, and characteristics of the cohort. Italian Collaborative Study Group.

The rationale and design of a large, multicentre, prospective follow-up study on the outcome of severe mental disorders is presented. The study is currently under way in Italy, where psychiatric care has been uniquely characterised since 1978 by the statutory prohibition of admitting patients to psychiatric hospitals. The main purpose of the study is to describe the 5-year outcome of patients with a diagnosis of schizophrenia, paranoid disorder, affective psychosis, reactive psychosis or personality disorder with respect to five areas (clinical condition, personal autonomy, work, and family and social relationships); a secondary objective is to describe the heterogeneity of practices and resources of psychiatric services. The study is being carried out by 76 outpatient psychiatric services throughout the country, covering approximately one-tenth of the Italian population.

Adult↗
PubMed1989

A hypothesis about the decline of fertility: evidence from the United States.

The author examines the relationships among fertility decline, urbanization, and the increase in personal autonomy in the United States during the nineteenth century. "Urbanization was consistently negatively correlated with the level of fertility in 1810, 1860, 1920, and 1940. Urbanization was not significantly correlated with the decline of fertility in the period, i.e. from 1800 to 1860; from 1860 to 1920; and from 1920 to 1940. For the period from 1800 to 1860, however, the decline was closely associated with a proxy variable for what is called the spirit of autonomy, i.e., a feeling of control over one's life. It is hypothesized that this sense of control extended to control over fertility. After 1860 the ideas became so widespread that they were no longer associated with any particular group, region, religion, or class. It was just a matter of time until the ideas spread slowly to all groups." (SUMMARY IN FRE)

Americas↗
PubMedDate not supplied

Ethics and family planning.

Ethical problems in the area of contraception include the respect for the autonomy/integrity of the woman/couple and the question of justice. Three leading principles in Western moral philosophy are discussed and applied to contraceptive practice. To uphold the principle of autonomy, the personal choice of the woman/couple must always be respected. The question of beneficence and non-maleficence must first be related to the individual and only second to the society. The principle of justice implies that resources should be allocated to those who need them; access to contraception should not depend upon an ability to pay for the services. If the 10-year-old United Nations 'Convention on the elimination of all forms of discrimination of women' is to come true during this decade, we must pay more attention to the respect for integrity and to the question of justice.

Beneficence↗
PubMed2005

Community without communitarianism: HIV/AIDS research, prevention and treatment in Australia and the developing world.

The advent of HIV focussed broad social attention on the group of people most affected by it in Australia, the so-called 'gay community'. However, what a gay community actually was, and what kind of rights and duties were being attached to it remained unclear. However, it is obvious that such a community--or communities--did not fit the model proposed by communitarian writers like Michael Sandel and Charles Taylor, whereby subjects cannot stand outside their own constitutive attachments. I also consider the common criticism of communitarianism, and see what kinds of collectives can in fact be considered ethical. The first part of the paper looks at the ethical issues surrounding community attachment of this kind in Australia in relation to the ethics of HIV/AIDS clinical research. In particular I examine the way in which certain forms of gay community attachment can be used to strengthen personal autonomy and check exploitation within the prevention and research process. The second part of this paper draws upon the issues just discussed. In particular I focus on the use of 'community' in the research process in developing countries, and suggest ways in which cultural considerations might strengthen autonomy. However, I go on to suggest that in many cases the idea of community has served the opposite purpose, and has in fact been used to oppress certain individuals and groups within the developing world, in the so-called interests of the greater good. In order to avoid this, I suggest a model of social and ethical research whereby all subjects and researchers in the clinical process might stand in greater relationships of equality with each other.

Acquired Immunodeficiency Syndrome↗