Abnormal moral reasoning in complete and partial callosotomy patients

Recent neuroimaging studies suggest lateralized cerebral mechanisms in the right temporal parietal junction are involved in complex social and moral reasoning, such as ascribing beliefs to others. Based on this evidence, we tested 3 anterior-resected and 3 complete callosotomy patients along with 22 normal subjects on a reasoning task that required verbal moral judgments. All 6 patients based their judgments primarily on the outcome of the actions, disregarding the beliefs of the agents. The similarity in performance between complete and partial callosotomy patients suggests that normal judgments of morality require full interhemispheric integration of information critically supported by the right temporal parietal junction and right frontal processes.     

A hybrid diagnosis model for determining the types of the liver disease

The symptoms of liver diseases are not apparent in the initial stage, and the condition is usually quite serious when the symptoms are obvious enough. Most studies on liver disease diagnosis focus mainly on identifying the presence of liver disease in a patient. Not many diagnosis models have been developed to move beyond the detection of liver disease. The study accordingly aims to construct an intelligent liver diagnosis model which integrates artificial neural networks, analytic hierarchy process, and case-based reasoning methods to examine if patients suffer from liver disease and to determine the types of the liver disease.     

The Wasi Matrix Reasoning Subtest

Previous research reported that the WAIS-III Matrix Reasoning (MR) subtest was insensitive to the effects of traumatic brain injury (TBI), learning disability, and attention deficit hyperactivity disorder. This study was conducted to determine whether these findings generalize to the Wechsler Abbreviated Scale of Intelligence (WASI) MR subtest and to explore the subtest's sensitivity to other brain disorders. When 81 brain-damaged patients completed the WASI, the MR subtest was the highest score in the profile. For subgroups of TBI and Dementia, MR yielded the highest mean T-score. For patients with stroke, MR was the second highest mean. Subtest comparisons with estimated premorbid IQ suggested MR might show selective sensitivity. Results indicated no predictive validity for TBI, whereas MR was sensitive to the cognitive sequelae of stroke and dementia.     

Language consistency: a missing link in theory,research and reasoning?

Title.  Language consistency: a missing link in theory, research and reasoning?
Aim.  This paper is a report of a study conducted to determine if there is a lack of language consistency in nursing texts and among nursing educators related to theory, research and reasoning.
Background.  Analysis of international language, communication and nursing literature revealed the essential role language consistency plays in promoting competency and desirable behavioural outcomes. It also revealed the difficulty nursing has had in gaining consistency of language associated with theory, research and reasoning.
Method.  Six nursing theory, research and terminology texts with international circulation were analysed to identify key words related to theory, research and reasoning and to determine consistency of definitions among texts. Next, 97 nursing educators were surveyed to determine their ability to define the same key words. Educators were recruited during three national nursing education meetings in the United States of America between 2006 and 2007.
Findings.  Analysis revealed significant variability in definitions of key words among texts and in nursing educators' ability to match any defining words used by the texts and by each other.
Conclusion.  Epistemologically, the use of inconsistent language among texts and educators may be playing a role in the continuing marginalization of theory, research and reasoning in nursing education and practice; ultimately, hindering the profession's epistemological growth. Recommendations include a call for consensus of key words and meanings associated with theory, research and reasoning and the development of a language essentials document to support development of competency.     

Is problem-based learning an ideal format for developing ethical decision skills?

Ethical decision making is a complex process, which involves the interaction of knowledge, skills, and attitude. To enhance the teaching and learning on ethics reasoning, multiple teaching strategies have to be applied. A medical ethical reasoning (MER) model served as a framework of the development of ethics reasoning and their suggested instructional strategies. Problem-based learning (PBL), being used to facilitate students' critical thinking, self-directed learning, collaboration, and communication skills, has been considered effective on ethics education, especially when incorporated with experiential experience. Unlike lecturing that mainly disseminates knowledge and activates the left brain, PBL encourages “whole-brain” learning. However, PBL has several disadvantages, such as its inefficiency, lack of adequately trained preceptors, and the in-depth, silo learning within a relatively small number of cases. Because each school tends to utilize PBL in different ways, either the curriculum designer or the learning strategy, it is important to maximize the advantages of a PBL session, PBL then becomes an ideal format for refining students' ethical decisions and behaviors.     

A narrative reasoning course to promote patient-centred practice in a physiotherapy undergraduate programme: a qualitative study of final year students

Abstract

Background: Narrative reasoning has been presented as a core component of the health professionals’ competencies.

Aim of the study: This study aimed to explore the students’ perspectives about the contribution of a narrative reasoning course to promote patient-centred practice.

Methods: An interpretative phenomenological analysis (IPA) was undertaken through focus groups. Eighteen volunteer final year students participated in three focus groups. Data analysis followed the IPA principles.

Findings: Three themes emerged: (1) “developing distinctive competencies”; (2) “shifting students’ focus” and (3) “challenging students’ professional identity”. In the first theme, students distinguished their capability to better understand patients’ experiences and needs and to be aware of the importance of a collaborative therapeutic relationship. In the second theme, students emphasized a shift from themselves as clinicians towards their patients. Finally, in the third theme participants shared the perspective that they have developed a different clinical profile, and that their reasoning and clinical actions have changed.

Conclusions: Students recognized the contribution of the course in developing competencies to facilitate patient-centred practice. Future research is needed to inform lecturers on how to best integrate narrative reasoning within the physiotherapy undergraduate curricula.     

辩论过程中论证的建构与评估

论证是辩论的核心 ,成功的辩论总是以论证的建构和评估为前提。建构一个正确而有效的论证首先需要确定彼此的争议所在 ,明确陈述己方主张并作为结论 ,进而提出理由以支持结论 ,然后考察相反的观点与论证 ,最后以可理解的方式对论证全过程加以组织和表达。论证的评估不仅包括对论证前提 (理由 )真实性的评估 ,而且包括对理由对推断的支持关系的评估。由于辩论是展开于主体间的、以消除争议谋求共识为目的的言语行为 ,其中的证明、反驳与辩护往往是以提问和回答的相互交替为表现形式 ,因此辩论过程中经常使用的是“批判性提问策略”的论证评估方法。     

护理本科教育中设置“护理临床推理与决策”课程的探讨

临床推理是医学各专业人员的核心能力，也是护生胜任护理实践的关键。研究表明：护生推理能力与病人安全、护理质量息息相关，如果护生临床推理能力差，常常导致病人发生意外。然而，目前护生临床推理能力表现并不理想。美国一项调查显示：     

Comprehending 3D Diagrams: Sketching to Support Spatial Reasoning

Science, technology, engineering, and mathematics (STEM) disciplines commonly illustrate 3D relationships in diagrams, yet these are often challenging for students. Failing to understand diagrams can hinder success in STEM because scientific practice requires understanding and creating diagrammatic representations. We explore a new approach to improving student understanding of diagrams that convey 3D relations that is based on students generating their own predictive diagrams. Participants’ comprehension of 3D spatial diagrams was measured in a pre- and post-design where students selected the correct 2D slice through 3D geologic block diagrams. Generating sketches that predicated the internal structure of a model led to greater improvement in diagram understanding than visualizing the interior of the model without sketching, or sketching the model without attempting to predict unseen spatial relations. In addition, we found a positive correlation between sketched diagram accuracy and improvement on the diagram comprehension measure. Results suggest that generating a predictive diagram facilitates students’ abilities to make inferences about spatial relationships in diagrams. Implications for use of sketching in supporting STEM learning are discussed.     

基于案例推理的高血压辅助诊疗方法研究

针对高血压临床诊疗过程中的案例数据进行处理与分析,提出基于案例推理的高血压辅助诊疗方法。对高血压复杂的案例数据进行整理分析,提取案例中的关键症状作为特征属性构成案例模版,对高血压案例的症状进行创新特征表达,并提出一种快速案例推理的检索方法。根据病理原理以及数据分析提出采用内省学习方法,不断学习案例症状属性的权重,实现更高效、更准确的案例匹配。辅助诊疗方法提高了案例推理的准确率与高效性,有助于提高高血压辅助诊疗的自动化水平。