The influence of information structuring and health literacy on recall and satisfaction in a simulated discharge communication

Objective

We investigated the effects of information structuring and its potential interaction with pre-existing medical knowledge on recall in a simulated discharge communication.

Is the difference between right and left ATLs due to the distinction between general and social cognition or between verbal and non-verbal representations?

The present review aimed to check two proposals alternative to the original version of the ‘semantic hub’ hypothesis, based on semantic dementia (SD) data, which assumed that left and right anterior temporal lobes (ATLs) store in a unitary, amodal format all kinds of semantic representations.The first alternative proposal is that the right ATL might subsume non-verbal representations and the left ATL lexical-semantic representations and that only in the advanced stages of SD, when atrophy affects the ATLs bilaterally, the semantic impairment becomes ‘multi-modal’.The second alternative suggestion is that right and left ATLs might underlie two different domains of knowledge, because general conceptual knowledge might be supported by the left ATL, and social cognition by the right ATL.Results of the review substantially support the first proposal, showing that the right ATL subsumes non-verbal representations and the left ATL lexical-semantic representations. They are less conclusive about the second suggestion, because the right ATL seems to play a more important role in behavioral and emotional functions than in higher level social cognition.     

How action schemas are reflected in young children’s emerging language

ABSTRACT

This paper draws on observational studies of three young children in order to demonstrate firstly, their intrinsic motivation to explore systematically through repeated patterns of action or ‘schemas’; secondly, how those repeated actions appear and are explored in their emerging language demonstrating their increasing construction of and understanding of complex concepts. Concepts being explored included seriation, capacity and fit and movement and direction. What emerged was the value of child initiated learning, supported sensitively by adults, who need to ‘tune in conceptually’ to the children’s play.     

浅析固体制剂厂房概念设计

从产品产能分析,总平面设计,工艺分析,隔离设计和平面布置等几个方面阐述了固体制剂厂房概念设计阶段需关注的要点,列举了设计中面临的风险,并提出了应对策略。     

First-person action experience reveals sensitivity to action efficiency in prereaching infants

Do infants learn to interpret others’ actions through their own experience producing goal-directed action, or does some knowledge of others’ actions precede first-person experience? Several studies report that motor experience enhances action understanding, but the nature of this effect is not well understood. The present research investigates what is learned during early motoric production, and it tests whether knowledge of goal-directed actions, including an assumption that actors maximize efficiency given environmental constraints, exists before experience producing such actions. Three-month-old infants (who cannot yet effectively reach for and grasp objects) were given novel experience retrieving objects that rested on a surface with no barriers. They were then shown an actor reaching for an object over a barrier and tested for sensitivity to the efficiency of the action. These infants showed heightened attention when the agent reached inefficiently for a goal object; in contrast, infants who lacked successful reaching experience did not differentiate between direct and indirect reaches. Given that the infants could reach directly for objects during training and were given no opportunity to update their actions based on environmental constraints, the training experience itself is unlikely to have provided a basis for learning about action efficiency. We suggest that infants apply a general assumption of efficient action as soon as they have sufficient information (possibly derived from their own action experience) to identify an agent’s goal in a given instance.A hallmark of goal-directed action is its flexibility (1). Intelligent agents draw on causal and functional knowledge to update their action plans based on the constraints and affordances of the current environment. As a result, the same goal can be achieved with various means depending on the situation, and the same movements can reflect diverse goals. This flexibility poses a nontrivial inference problem for the outside observer seeking to uncover agents’ intentions and predict their future behavior.Humans nonetheless make sense of others’ behavior, and do so by recruiting a “theory of mind” that relates observable actions to subjective mental states (2). This intuitive theory relies on a key assumption that agents are rational, pursuing their goals with the most efficient means possible in a given context (3, 4). By assuming that agents pursue their goals efficiently, an observer can flexibly adapt expectations about others’ actions to the constraints of a given situation, and can interpret the same actions differently based on the context. This efficiency assumption thus constrains an otherwise underdetermined inference problem, providing a flexible schema for explaining and predicting action.     

From the Cover: Young infants have biological expectations about animals

What are the developmental origins of our concept of animal? There has long been controversy concerning this question. At issue is whether biological reasoning develops from earlier forms of reasoning, such as physical and psychological reasoning, or whether from a young age children endow animals with biological properties. Here we demonstrate that 8-mo-old infants already expect novel objects they identify as animals to have insides. Infants detected a violation when an object that was self-propelled and agentive (but not an object that lacked one or both of these properties) was revealed to be hollow. Infants also detected a violation when an object that was self-propelled and furry (but not an object that lacked one or both of these properties) either was shown to be hollow or rattled (when shaken) as although mostly hollow. Young infants’ expectations about animals’ insides may serve as a foundation for the development of more advanced biological knowledge.By the end of the preschool years, children possess considerable biological knowledge. In particular, they expect the insides of animals to be different from those of artifacts (1, 2); they realize that the insides of an animal are essential for its functioning (e.g., a dog cannot bark after its insides are removed) (3, 4); and they are beginning to understand that certain behaviors, such as eating and drinking, are necessary to maintain the continued functioning of animals and their insides (5, 6). This biological knowledge is often characterized as a vitalistic biology, in which internal organs and their workings sustain the vitality or life force of animals (7–10). A few facets of this vitalistic biology are already in place by the start of the preschool years. Thus, although 3-y-old children lack specific knowledge about the insides of animals (1, 2), they do expect these insides to differ from those of artifacts. When asked whether a pig has the same kinds of insides as a cow or a piggy bank, for example, 3-y-olds are more likely to select the cow (3). Similarly, when told that dogs have “andro” inside, 3-y-olds are more likely to project this novel property to other animals (including mammals and nonmammals) than to artifacts (11).Does young children’s vitalistic biology have roots in infancy? Do infants possess abstract expectations about animals that could lay the foundations for the acquisition of more sophisticated biological knowledge? Below, we consider two broad hypotheses concerning this issue; we refer to them as the “nonbiological” and the “biological” hypotheses.According to the nonbiological hypothesis, infants do not endow animals with vitalistic or biological properties: animals are simply entities that are self-propelled and agentive [for infants, these two properties are conceptually distinct (12–14); objects may be self-propelled without being agentive, and they may be agentive without being self-propelled]. Proponents of the nonbiological hypothesis differ greatly in their theoretical views on how infants come to understand self-propulsion and agency. To illustrate, consider two such views: the core-domain and image-schema views. According to the core-domain view (15), infants’ concept of self-propulsion is part of the skeletal explanatory framework that underlies core physical reasoning: when a novel object gives evidence that it is capable of autonomous motion (e.g., begins to move on its own), infants attribute to the object an internal source of energy, and they appreciate that the object may use its energy to reverse course, resist efforts to move it, and so on (16). Similarly, infants’ concept of agency is part of the skeletal explanatory framework that underlies core psychological reasoning: when a novel object provides evidence that it has autonomous control over its actions (e.g., responds contingently to events in its environment), infants attribute to the object motivational, epistemic, and other internal states, and they use these states to predict and interpret the object’s actions (17). In contrast, according to the image-schema view (18), infants’ concepts of self-propulsion and agency are formed by a perceptual-meaning-analysis mechanism that redescribes spatiotemporal information into meaningful iconic representations. Thus, self-propelled objects are those that start moving by themselves, without contact with other objects, whereas agentive objects are those that interact contingently with other objects, again without contact. In the image-schema view, infants have no notion of internal energy or internal states; these concepts are acquired later in development as enrichments of primitive spatial concepts. Despite their marked differences, however, both the core-domain and image-schema views assume that animals are, for infants, no more than self-propelled agents.This assumption contrasts with the biological hypothesis, which admits the possibility that infants ascribe to entities that are self-propelled and agentive additional properties that are vitalistic or biological in nature (19–22). What might these biological properties be? One proposal, put forth by Gelman (19), is that infants are born with an “innards” principle: self-propelled agents have insides that make possible their behavior. According to Gelman (19), “the principle is neutral with respect to the nature of what a child or anyone may think is in the inside.” The innards principle is, of course, consistent with the findings on vitalistic biology mentioned earlier: children might at first simply expect animals to have insides, and with experience they might gradually learn how the insides of animals differ from those of artifacts (1), how the insides of one kind of animal differ from those of another kind of animal (23), and so on. In line with the innards principle, Gelman (19) found that when children age 3 and older were queried about the insides of various artifacts and animals, they sometimes said that an artifact had nothing on the inside, but they never said that an animal had nothing on the inside (see also refs. 24 and 25).Is the nonbiological or the biological hypothesis correct? Do infants construe animals simply as self-propelled agents, or do they endow animals with additional, biological properties? One way to address these questions is to examine whether infants expect novel self-propelled agents to have insides, in accordance with the innards principle. Therefore, we used the violation-of-expectation method to test whether infants would detect a violation when a novel object that was self-propelled and agentive—but not an object that lacked one or both of these properties—was revealed to be hollow. Because there is considerable evidence that infants in the second half-year are sensitive to various cues for self-propulsion and agency (12, 26), our experiments focused on 8-mo-old infants. We reasoned that positive results would support the biological hypothesis by demonstrating that young infants immediately endow novel self-propelled agents with vitalistic, biological properties. Such results would be unique in providing an experimental demonstration that abstract biological expectations about animals are present in the first year of life.Although no prior experiment had examined whether infants expect animals to have insides, previous findings with 14-mo-olds indicated that, when shown novel objects with eyes and visible insides, infants do notice these insides. Thus, infants assigned perceptually different objects to the same category if they possessed similar insides (27); infants readily formed an association between a transparent object’s self-propelled motion and the presence of an internal part (28); and infants also readily associated a transparent object’s particular style of self-propelled motion with the color of its internal part (28). Broadly construed, these findings suggested that infants attend to the insides of animals. Building on these findings, we asked in four experiments whether 8-mo-old infants would expect novel objects they identified as animals to have insides. All of the experiments followed the same general design. During the familiarization phase, infants were introduced to two novel objects; across conditions, we varied whether or not the objects were capable of self-propulsion and agency. During the test phase, the objects were rotated (Exps. 1–3) or shaken (Exp. 4) to assess infants’ expectations about their insides.In Exp. 1, 8-mo-old infants from English-speaking families (n = 36) were assigned to a self-propelled/agentive condition or a nonself-propelled/nonagentive condition. Infants watched live events involving two novel objects: a large can covered with alternating stripes of red and gray yarn and a large box covered with beige paper and varying round patches of blue cloth with multicolored dots. All infants received two familiarization trials, two pretest trials, and two test trials, one with the can and one with the box; half of the infants received the can trial first in each pair of trials, and half received the box trial first. Only the familiarization trials differed between the two conditions. Each familiarization trial had an initial phase and a final phase; looking times during the two phases were computed separately. At the beginning of the (76 s) initial phase of the can trial in the self-propelled/agentive condition (Fig. 1A), the can rested at the center of the apparatus floor. To start, the can moved in a slight bouncing manner back and forth across the floor and then returned to its original position [this displacement lasted about 16 s and served to establish that the can was self-propelled (16)]. Next, a female experimenter opened a window in the back wall of the apparatus; the can then initiated a “conversation” by quacking at the experimenter, who responded contingently in English [this exchange lasted about 49 s and served to demonstrate that the can was agentive (17)]. Finally, the experimenter left, closing her window behind her. During the final phase of the trial, the can rested at the center of the apparatus, and infants watched this paused scene until the trial ended. The box familiarization trial was identical except that the box moved in a slight zigzag manner and beeped at the experimenter. Infants in the nonself-propelled/nonagentive condition (Fig. 1B) received similar familiarization trials except that the can and box remained stationary [thus providing no evidence that they were self-propelled (16)], and the experimenter remained silent in response to the can’s quacks or the box’s beeps [thus providing no evidence that they were agentive (14)].Open in a separate windowFig. 1.Schematic drawing of the events shown in Exps. 1 and 2. In Exp. 1, the can and box were either self-propelled and agentive (A) or neither self-propelled nor agentive (B). In Exp. 2, the can and box were self-propelled and agentive (A), self-propelled but nonagentive (C), or nonself-propelled but agentive (D). Whether the can trial or the box trial was shown first in the familiarization (A–D), pretest (E), and test (F) trials was counterbalanced across infants in each condition; whether the can or the box was hollow in the test trials was also counterbalanced across infants in each condition.Next, all infants received the can and box pretest trials (Fig. 1E), which served to introduce the actions performed in the test trials. In each trial, the experimenter lifted the can or box with both hands, tilted it right and left twice, returned it to the apparatus floor, and then repeated this entire (12 s) sequence until the trial ended. Finally, all infants received the can and box test trials (Fig. 1F). These trials were identical to the pretest trials except that, before tilting the can or box from side to side, the experimenter rotated it to reveal its bottom to the infant. When the objects were rotated, infants could see that one was hollow, like an inverted bowl (hollow trial), whereas the other one was closed, like a block (closed trial). For half the infants in each condition, the can was hollow and the box was closed; for the other infants, the reverse was true. Preliminary analyses of the test data in this report revealed no interactions of condition and trial with infants’ sex; the data were therefore collapsed across this factor in subsequent analyses.Infants’ looking times during the test trials (Fig. 2) were analyzed by means of an ANOVA with condition and order as between-subject factors and trial as a within-subject factor. The Condition X Trial interaction was significant, F(1, 32) = 6.11, P = 0.019 [no such interaction was found in an analysis of the final phases of the familiarization trials or in an analysis of the pretest trials, both Fs (1, 32) < 1]. Planned comparisons revealed that in the self-propelled/agentive condition, infants looked reliably longer during the hollow than the closed trial, F(1, 32) = 10.08, P = 0.003; 14 of 18 infants showed this pattern. In contrast, in the nonself-propelled/nonagentive condition, infants looked about equally during the two trials, F(1, 32) < 1; 7 of 18 infants looked longer at the hollow event. Thus, infants detected a violation when the can and box were shown to be hollow, but only if they were self-propelled agents; if the objects were neither self-propelled nor agentive, infants held no expectations about whether they should have insides.Open in a separate windowFig. 2.Mean looking times of infants in Exps. 1–3 during the test trials as a function of condition and trial. Errors bars represent SEs, and an asterisk denotes a significant difference between the trials within a condition (P < 0.05 or better).Exp. 2 investigated the specificity of infants’ expectations about what objects should have insides. According to the innards principle, infants should expect novel objects that are both self-propelled and agentive to have insides, but they should hold no expectation for objects that are only self-propelled or only agentive. To evaluate this prediction, additional 8-mo-old infants from English-speaking families (n = 54) were assigned to one of three conditions. The self-propelled/agentive condition was identical to that in Exp. 1 (Fig. 1A). The other two conditions were similar, except that in the familiarization trials, either the experimenter remained silent [self-propelled/nonagentive condition (Fig. 1C)], or the can and box remained stationary [nonself-propelled/agentive condition (Fig. 1D)].Analysis of infants’ looking times during the test trials (Fig. 2) revealed a significant Condition X Trial interaction, F(2, 48) = 3.64, P = 0.034 [no such interaction was found in an analysis of the final phases of the familiarization trials, F(2, 48) < 1, or in an analysis of the pretest trials, F(2, 48) = 1.28, P = 0.289]. In the self-propelled/agentive condition, as before, infants looked reliably longer during the hollow than the closed trial, F(1, 48) = 7.82, P = 0.007; 14 of 18 infants showed this pattern. In contrast, infants looked about equally during the two trials in both the self-propelled/nonagentive and nonself-propelled/agentive conditions, both Fs < 1; 8 of 18 infants in self-propelled/nonagentive condition and 9 of 18 infants in the nonself-propelled/agentive condition looked longer during the hollow trial. Thus, infants expected the can and box to have insides only if they were self-propelled and agentive; if they lacked either property, infants held no expectations about their insides.The results of Exps. 1 and 2 indicated that when a novel object gives evidence that it is capable of both autonomous motion and control, young infants identify it as an animal and immediately expect it to have insides, in accordance with the innards principle. These results provided direct support for the biological hypothesis by demonstrating that young infants possess abstract biological expectations about animals. Exp. 3 sought to provide converging evidence for these conclusions: it examined whether young infants would also expect novel animals identified via learned predictive cues to have insides.Proponents of both the nonbiological and biological hypotheses assume that, with experience, infants learn to use details of surface appearance and form as cues that novel objects are animals (this cue-learning process enables infants to rapidly identify novel animals without having to wait for evidence of autonomous motion and control). For example, previous research indicates that by 7 mo of age, infants already use fur on a self-propelled object as a cue that the object is an animal (29). When a ball and a furry object with a face moved together in close contact, infants attributed the source of the motion to the furry object; when the two objects later rested stationary side by side, infants looked reliably longer at the furry object as though they anticipated that it would move again. However, no such effect was found when an experimenter moved the ball and the furry object together with her hand. (In a survey we conducted of parents of 35 6- to 9-mo-old infants, 83% reported that their infant had touched a furry animal at least once, and 60% reported that their infant had regular contact with one or more furry animals. These results support the notion that infants in the second half-year have opportunities to identify fur as a predictive cue for animals). Building on these results, we asked in Exp. 3 whether 8-mo-old infants would expect an object that was furry and self-propelled, but not an object that lacked one or both of these properties, to have insides.Infants (n = 36) were assigned to a self-propelled or a nonself-propelled condition and watched events involving a new can that was covered with brown beaver fur and a new box that was covered with tan paper and edged with brown tape (Fig. 3). During the (32 s) initial phase of each familiarization trial in the self-propelled condition, the fur-can or box moved smoothly back and forth across the apparatus floor to demonstrate that it was self-propelled; during the final phase, the object paused at the center of the apparatus until the trial ended. The familiarization trials in the nonself-propelled condition were identical except that the fur-can and box rested on a tray, and the experimenter reached through a window in the back wall of the apparatus to move the tray back and forth. Next, all infants received pretest and test trials identical to those in Exp. 1, except that the fur-can (fur-can trial) and box (box trial) were both revealed to be hollow.Open in a separate windowFig. 3.Schematic drawing of the events shown in Exp. 3. Whether the fur-can trial or the box trial was shown first in the familiarization (A and B), pretest (C), and test (D) trials was counterbalanced across infants in each condition.Analysis of infants’ looking times during the test trials (Fig. 2) yielded a significant Condition X Trial interaction, F(1, 32) = 6.18, P = 0.018 [no such interaction was found in an analysis of the final phases of the familiarization trials or in an analysis of the pretest trials, both Fs (1, 32) < 1]. In the self-propelled condition, infants looked reliably longer during the fur-can than the box trial, F(1, 32) = 12.00, P = 0.002; 16 of 18 infants showed this pattern. In contrast, infants in the nonself-propelled condition looked about equally during the two trials, F(1, 32) < 1; 9 of 18 infants looked longer during the fur-can trial. Thus, infants expected the self-propelled fur-can to have insides, but they held no expectations about the insides of the nonself-propelled fur-can or about those of the box, whether it was self-propelled or not. These results also provide additional evidence that by 8 mo, infants use fur on a self-propelled object as a cue that it is an animal.In Exps. 1–3, infants detected a violation when an object they had identified as an animal was rotated to reveal that it had no insides. To provide converging evidence for these results, in Exp. 4 we used a different manipulation to assess 8-mo-olds’ expectations about insides: instead of rotating the fur-can and box from Exp. 3, the experimenter shook each object to demonstrate that it rattled, as though the shaking caused a few parts to bounce inside the object’s largely hollow interior. If infants expected the self-propelled fur-can to have insides, they should detect a violation when it produced a rattling noise when shaken, as though it was mostly hollow inside. (To check our manipulation, we presented 20 adults with the rattling fur-can and the rattling box, and we asked them to estimate based on the sounds they heard how full each object was inside. On average, subjects guessed that the objects were 28% full, supporting our claim that the rattling sounds conveyed that the objects were largely hollow.)Infants (n = 51) were assigned to a self-propelled, a nonself-propelled, or a silent-control condition (Fig. 4). In the self-propelled condition, infants received the same fur-can and box familiarization trials as in the self-propelled condition of Exp. 3 for two pairs of trials. Next, infants received either a fur-can or a box test trial. During the (25 s) initial phase of each trial, the experimenter’s gloved hands (which reached through a curtained window in the right wall of the apparatus) first grasped the fur-can or box. Next, the hands lifted the object, shook it (causing it to rattle), and returned it to the apparatus floor; this sequence was repeated two more times, and then the hands rested on either side of the object. During the final phase, infants watched this paused scene until the trial ended (pilot data indicated that infants tended to look continuously if the rattling persisted, so this nonrepeating procedure was used instead). The nonself-propelled condition was identical, except that in the familiarization trials the fur-can and box rested on a tray and the experimenter’s right gloved hand moved the tray back and forth on the apparatus floor. Finally, because infants in the self-propelled condition might look longer when the fur-can rattled not because they expected it to have insides but because they had never seen an animal being shaken before, a silent-control condition was also included. This condition was identical to the self-propelled condition except that in the test trials the objects produced no noise when shaken. In the self-propelled and nonself-propelled conditions, nine infants received a fur-can test trial and eight infants received a box test trial; in the silent-control condition, these numbers were reversed.Open in a separate windowFig. 4.Schematic drawing of the events shown in Exp. 4. Whether the fur-can trial or the box trial was shown first in the familiarization trials (A and B) was counterbalanced across infants in each condition. In the test trial (C), infants saw either the fur-can or the box trial. The silent-control condition (not shown) was identical to the self-propelled condition except that in the test trial the fur-can or box produced no noise when shaken.Analyses of infants’ looking times during the final phase of the test trial (Fig. 5) yielded a significant Condition X Trial interaction, F(2, 45) = 4.85, P = 0.012 [no such interaction was found in an analysis of infants’ averaged looking times during the final phases of the fur-can and box familiarization trials, F(2, 45) < 1]. In the self-propelled condition, infants looked reliably longer if shown the fur-can as opposed to the box trial, F(1, 45) = 16.08, P = 0.0002. In contrast, in the nonself-propelled and silent-control conditions, infants looked about equally during either trial, both Fs (1, 45) < 1. Thus, infants detected a violation when the fur-can produced a rattling noise when shaken, but only if it was self-propelled. These results provided converging evidence that infants identify self-propelled furry objects as animals and expect their insides to be filled as opposed to hollow.Open in a separate windowFig. 5.Mean looking times of infants in Exp. 4 during the final phase of the test trial as a function of condition and trial. Errors bars represent SEs, and an asterisk denotes a significant difference between the trials within a condition (P < 0.05 or better).The present experiments indicate that 8-mo-old infants expect a novel object they identify as an animal to have insides, in accordance with the innards principle. This identification may come about because the object gives evidence of autonomous motion and control, or because it presents cues with learned predictive validity for distinguishing animals from other objects. In either case, upon identifying the novel object as an animal, infants immediately expect it to have insides: they detect a violation if the object either is shown to be hollow or rattles when shaken as although mostly hollow. Taken together, these results provide strong support for the biological hypothesis that infants endow animals with vitalistic, biological properties.At least two broad questions remain for future research. First, what general expectations do infants possess about animals’ insides? For example, would infants expect the insides of a novel object that was self-propelled and agentive to differ from those of an object that lacked these properties? Moreover, would infants regard an animal’s insides as essential for its functioning? If infants witnessed the removal of the insides of a novel self-propelled agent, would they expect it to no longer be capable of autonomous motion and control?Second, how should we conceptualize infants’ expectations about animals’ insides? There are at least three possibilities. One is that these early expectations are part of a skeletal explanatory framework that underlies core biological reasoning (21). In this view, infants would possess a naïve theory of biology as well as naïve theories of physics and psychology, although their naïve theory of biology might be less rich. Another possibility is that infants’ expectations about insides reflect general biases or modes of construal that are not exclusively tailored for biological phenomena (30, 31). For example, abstract biases for teleology and essentialism, perhaps with sparse conceptual constraints, might lead infants to posit various internal features to explain objects’ capacity for self-propulsion (internal energy), for agency (internal states), and for both self-propulsion and agency (innards). Finally, a third possibility is that infants’ expectations about insides arise from a quite different source: the cognitive systems that humans evolved to deal with predators and prey and, more generally, to understand animals as a food source (32). As Barrett (32) noted, “Predators are things that systematically try to kill you and eat you. Prey are things you try to capture and eat.” From this perspective, it seems plausible that the human mind would have evolved an abstract expectation that animals have filled insides. Damaging the insides of a predator or prey brings about its demise, and consuming these insides provides valuable nutrients. Why would an expectation of filled insides apply to entities that are both self-propelled and agentive, but not to entities that are only self-propelled or only agentive? It could be that in the evolution of predator-prey adaptations, the systems for detecting self-propulsion came first, and those for detecting agency were integrated later as they became available; understanding animals as self-propelled agents would have presented significant advantages for predator evasion and prey capture.Whichever possibility turns out to be correct, there can be no doubt that infants’ expectations about animals are highly primitive and that considerable conceptual elaboration and change must occur for young children to develop a more advanced understanding of biology. Nevertheless, the present research fits well with several developmental results. If infants construe animals as self-propelled agents with biological properties, then it makes sense that (i) young children initially have difficulty constructing a category of living things that includes plants as well as animals (33, 34); (ii) young children who are taught that plants engage in self-propelled, agentive motion immediately infer that plants are living things (35); and (iii) school-aged children and adults who see computer-animated blobs engage in self-propelled, agentive motion describe them as alive and attribute to them various biological properties (36). All of these results suggest that key components of the interpretive framework that guides infants’ expectations about animals persist throughout life.     

A multidimensional model of optimal participation of children with physical disabilities

Abstract

Purpose: To present a conceptual model of optimal participation in recreational and leisure activities for children with physical disabilities. Methods: The conceptualization of the model was based on review of contemporary theories and frameworks, empirical research and the authors’ practice knowledge. A case scenario is used to illustrate application to practice. Results: The model proposes that optimal participation in recreational and leisure activities involves the dynamic interaction of multiple dimensions and determinants of participation. The three dimensions of participation are physical, social and self-engagement. Determinants of participation encompass attributes of the child, family and environment. Experiences of optimal participation are hypothesized to result in long-term benefits including better quality of life, a healthier lifestyle and emotional and psychosocial well-being. Conclusion: Consideration of relevant child, family and environment determinants of dimensions of optimal participation should assist children, families and health care professionals to identify meaningful goals and outcomes and guide the selection and implementation of innovative therapy approaches and methods of service delivery.

• Implications for Rehabilitation

• Optimal participation is proposed to involve the dynamic interaction of physical, social and self-engagement and attributes of the child, family and environment.

• The model emphasizes the importance of self-perceptions and participation experiences of children with physical disabilities.

• Optimal participation may have a positive influence on quality of life, a healthy lifestyle and emotional and psychosocial well-being.

• Knowledge of child, family, and environment determinants of physical, social and self-engagement should assist children, families and professionals in identifying meaningful goals and guiding innovative therapy approaches.

     

From disablement to enablement: Conceptual models of disability in the 20th century

Purpose. The aim of this work is to provide a general view of the conceptual elaborations on disablement in the 20th century and to discuss the role of these different contributions in developing the current concepts of disablement.

Method. A review of the literature on conceptual models of disablement in the past century has been performed.

Results. The 20th century has witnessed important theoretical considerations on health, diseases and their consequences. These considerations have generated various conceptual models, some of which share the same focus and point of arrival, the so-called ‘Disablement Process’. Among the models that were developed, two stand out, which were drafted and disseminated under the aegis of the World Health Organization, namely the International Classification of Impairments, Disabilities and Handicaps (ICIDH) and the International Classification of Functioning, Disability and Health (ICF), but these are just one part of the conceptual elaboration in the field. Further conceptualization was produced in health and social settings by specialists, self-advocacy associations and activist groups.

Conclusions. The current ICF model of the World Health Organization has been translated and recognized in 191 countries; it also incorporates the contribution of self-advocacy associations and it is now recognized by most of them. This model has enjoyed higher visibility than other conceptual models, though its level of development was not higher or more original. To our opinion the ICF is not very clear on the essential choice of the model, i.e., to see disablement as a dynamic process that happens when personal limits collide with socio-environmental needs, rather than as a personal feature. This choice is instead clearer in other models, like Nagi's 1991, the Institute of Medicine (IOM) model by Brandt and Pope, where the identification of three dimensions (the individual, the environment and the individual-environment interaction) clarifies the role played by all three dimensions within the process of disablement and introduces major hints for further considerations on how to create virtuous processes of enablement.     

Addressing social inequity through improving relational care: A social–ecological model based on the experiences of migrant women and midwives in South Wales

BackgroundMigrant and ethnic inequalities in maternal and perinatal mortality persist across high‐income countries. Addressing social adversity and inequities across the childbirth trajectory cannot be left to chance and the good intentions of practitioners. Robust, evidence‐based tools designed to address inequity by enhancing both the quality of provision and the experience of care are needed.MethodsAn inductive modelling approach was used to develop a new evidence‐based conceptual model of woman–midwife relationships, drawing on data from an ethnographic study of relationships between migrant Pakistani women and midwives, conducted between 2013 and 2016 in South Wales, UK. Key analytic themes from early data were translated into social–ecological concepts, and a model was developed to represent how these key themes interacted to influence the woman–midwife relationship.ResultsThree key concepts influencing the woman–midwife relationship were developed from the three major themes of the underpinning research: (1) Healthcare System; (2) Culture and Religion; and (3) Family Relationships. Two additional weaving concepts appeared to act as a link between these three key concepts: (1) Authoritative Knowledge and (2) Communication of Information. Social and political factors were also considered as contextual factors within the model. A visual representation of this model was developed and presented.ConclusionsThe model presented in this paper, along with future work to further test and refine it in other contexts, has the potential to impact on inequalities by facilitating future discussion on cultural issues, encouraging collaborative learning and knowledge production and providing a framework for future global midwifery practice, education and research.Patient or Public ContributionAt the outset of the underpinning research, a project involvement group was created to contribute to study design and conduct. This group consisted of the three authors, an Advocacy Officer at Race Equality First and an NHS Consultant Midwife. This group met regularly throughout the research process, and members were involved in discussions regarding ethical/cultural/social issues, recruitment methods, the creation of participant information materials, interpretation of data and the dissemination strategy. Ideas for the underpinning research were also discussed with members of the Pakistani community during community events and at meetings with staff from minority ethnic and migrant support charities (BAWSO, Race Equality First, The Mentor Ring). Local midwives contributed to study design through conversations during informal observations of antenatal appointments for asylum seekers and refugees.