With places at nursery school promised for every child above the age of four, this book raises the stakes by looking at the quality of what is provided, and how that compares to what should be provided. Beyond Quality In Early Childhood Education and Care challenges received wisdom and the tendency to reduce philosophical issues of value to purely technical issues of measurement and management. In its place, it offers alternative ways of understanding early childhood, early childhood institutions and pedagogical (...) work. The book places issues of early childhood into a global context and relates them to writers from many fields. Drawing on work with aboriginal peoples in Canada, on the experience of Reggio-Emilia in Italy and on a project in Stockholm inspired by Reggio, the book considers the implications of these alternative ways of understanding, for practice and a reconceptualization of early childhood education and care. (shrink)

Four studies examined 15- to 16-month-olds’ imitation of a model’s novel action with a familiar or an unfamiliar object. The infants observed a reliable or an unreliable model demonstrating a novel action with the object in a solitary observational or in an interactive context. The model’s reliability was manipulated by having the model acting competently or incompetently with different familiar objects. In two out of four studies infants imitated the model’s behavior when the model had previously shown to be reliable (...) than when the model had been unreliable. The infants’ motivation to imitate was related to whether the reliable model interacted with the infants during object demonstration. More infants imitated the reliable model, who demonstrated the objects while interacting with the infants, than the reliable model who behaved in a disinterested manner during object demonstration. (shrink)

What this book is about -- Theoretical perspectives : modernity and postmodernity, power and ethics -- Constructing early childhood institution : what do we think it is? -- Constructing the early childhood institution : what do we think they are for? -- Beyond the discourse of quality to the discourse of meaning making -- The stockholm project : constructing a pedagogy that speaks in the voice of the child, the pedagogue and the parent -- Pedagogical documentation : a practice for (...) reflection and democracy -- Minority directions in the majority world : threats and possibilities. (shrink)

The article investigates the complex negotiation process regarding the renovation of St Catherine’s church in St Petersburg. Additionally, the goal is to gain novel understanding of how former religious spaces can be transformed and highlight the various significances these structures may possess in different contexts, particularly at the junction of religion and cultural heritage. Built in 1865, the church served as a place of worship for the Swedish-speaking congregation for nearly eighty years before being repurposed as a sports school. Recently, (...) Sweden has aimed to restore the church and utilize it as a centre for Swedish–Russian relations. The article examines the reasons and arguments for renovation, as well as the progress that has been made to date. Additionally, it explores the role of Sweden in Russia through the perspectives of various stakeholders, including members of the congregation, diplomats, politicians, architects and priests. (shrink)

This study examines the use of praise in caregiving of nursing home residents with dementia in Sweden. The data consist of video-recordings of staff–resident interaction in residential care settings where caregivers assist residents with personal hygiene. High-grade assessments accomplishing praise or a compliment such as ‘jättebra’ are routinely used online, simultaneously with the care activity, by the caregiver when the residents are requested to undertake manual tasks on their own, such as tooth brushing, washing, dressing, and getting out of bed. (...) It is shown that the primary function of the assessments is to encourage someone to do something, which is discussed as an institutionally related problem. These results contrast with prior research on domiciliary care in Sweden and Denmark, which show that high-grade assessment terms formulated so as to accomplish praise or a compliment are reserved for situations where the home helper’s institutional role as the senior citizen’s helping hand is downplayed. It is argued that a more sensitive use of assessments and a higher awareness of the social norms concerning epistemic primacy may be a step toward implementing person-centeredness in residential care for older people. (shrink)

Current diagnostic criteria for schizophrenia place emphasis on delusions and hallucinations, whereas the classical descriptions of schizophrenia by Kraepelin and Bleuler emphasized disorganization and impoverishment of mental activity. Despite the availability of antipsychotic medication for treating delusions and hallucinations, many patients continue to experience persisting disability. Improving treatment requires a better understanding of the processes leading to persisting disability. We recently introduced the term classical schizophrenia to describe cases with disorganized and impoverished mental activity, cognitive impairment and predisposition to persisting (...) disability. Recent evidence reveals that a polygenic score indicating risk for schizophrenia predicts severity of the features of classical schizophrenia: disorganization, and to a lesser extent, impoverishment of mental activity and cognitive impairment. Current understanding of brain function attributes a cardinal role to predictive coding: the process of generating models of the world that are successively updated in light of confirmation or contradiction by subsequent sensory information. It has been proposed that abnormalities of these predictive processes account for delusions and hallucinations. Here we examine the evidence provided by electrophysiology and fMRI indicating that imprecise predictive coding is the core pathological process in classical schizophrenia, accounting for disorganization, psychomotor poverty and cognitive impairment. Functional imaging reveals aberrant brain activity at network hubs engaged during encoding of predictions. We discuss the possibility that frequent prediction errors might promote excess release of the neurotransmitter, dopamine, thereby accounting for the occurrence of episodes of florid psychotic symptoms including delusions and hallucinations in classical schizophrenia. While the predictive coding hypotheses partially accounts for the time-course of classical schizophrenia, the overall body of evidence indicates that environmental factors also contribute. We discuss the evidence that chronic inflammation is a mechanism that might link diverse genetic and environmental etiological factors, and contribute to the proposed imprecision of predictive coding. (shrink)

The present study examined 17-month-olds’ imitation in a third-party context. In four experiments, the infants watched while a reliable or an unreliable model demonstrated a novel action with an unfamiliar (Experiments 1 and 3) or a familiar (Experiments 2 and 4) object to another adult. In Experiments 3 and 4, the second adult imitated the model’s novel action. Neither the familiarity of the object or whether or not the second adult copied the model’s behavior influenced the likelihood of infant imitation. (...) Findings showed that the infants in the reliable model condition were more willing to imitate the model’s action with the unfamiliar object. The results suggest that infants take into account the reliability of a model even when the model has not directly demonstrated her reliability to the infant. (shrink)

The aim of this article is to present re-enactment interviewing and to propose that it can be used to reveal tacit caring knowledge. This approach generates knowledge not readily attainable by other research methods, which we demonstrate by analysing the epistemological and methodological underpinnings of re-enactment interviewing. We also give examples from a study where re-enactment was used. As tacit knowledge is often characteristic of care, re-enactment interviewing has the potential to engage the informant in a holistic mode and thereby (...) reveal wisdom of the body. When the care provider recalls an event, the details are articulated, which contributes to in-depth data, which subsequently serves as a basis for trustworthy analysis. (shrink)

The current study examined whether infants use previous encounters for maintaining expectations for adults’ contingent responding. An unfamiliar adult responded contingently or non-contingently to infant signaling during an initial play situation and 10 min later presented an ambiguous toy while providing positive information (Experiment 1; forty-two 12-month-olds). The infants in the contingent group looked more at the adult during toy presentation and played more with the toy during the concluding free-play situation than the infants in the non-contingent group. When the (...) parent had responded contingently or non-contingently to infant bids (Experiment 2; forty 12-month-olds), the infants in the contingent group tended to look more at the parent and tended to play more with the toy than did the infants in the non-contingent group. The results indicate that from just a brief exposure, infants form expectations about adults’ responsiveness and maintain these expectations of contingent/non-contingent responding from one situation to another. (shrink)

In two separate experiments, we examined 17-month-olds’ imitation in a third-party context. The aim was to explore how seeing another person responding to a model’s novel action influenced infant imitation. The infants watched while a reliable model demonstrated a novel action with a familiar (Experiment 1) or an unfamiliar (Experiment 2) object to a second actor. The second actor either imitated or did not imitate the novel action of the model. Fewer infants imitated the model’s novel behavior in the non-imitation (...) condition than in the imitation condition in Experiment 1. In Experiment 2, infants’ likelihood of imitating was not influenced by whether they had watched the second actor imitating the model’s novel action with the unfamiliar object. The findings indicate that infants take into account a second adult’s actions in a third party context when infants receive information that contradicts their existing knowledge and when it corresponds with their own experiences. If infants do not have prior knowledge about how to handle a certain object, then the second adult’s actions do not seem to matter. (shrink)

Person‐centred care, with its central focus on the patient in partnership with healthcare practitioners, is considered to be the contemporary gold standard of care. This type of care implies effective communication from and by both the patient and the healthcare practitioner. This is often problematic in the case of the paediatric population, because of the many communicative challenges that may arise due to the child's developmental level, illness and distress, linguistic competency and disabilities. The principle of universal design put forth (...) in conventions and legislation means that the design of products and services should be usable by all people, to the greatest extent possible. Augmentative and alternative communication encompasses strategies, for example pictures and apps, that are typically used with people with communication disability. In this position paper, we argue for the universal use of augmentative and alternative communication to support person‐centred communication and care for children, regardless of age or potential disability. Clinical examples are shared from three different paediatric care settings where pictorial supports were applied universally. Interviews were conducted with children and adolescents (with and without disabilities), parents and healthcare practitioners, and the principles of universal design were used as a framework to demonstrate how person‐centred communication is supported in paediatric care. (shrink)

This article introduces evolutionary psychology to a general readership, with the purpose of applying evolutionary psychology to suicide terrorism. Some of the key concepts related to evolutionary psychology are discussed, as well as several misconceptions associated with this approach to psychology. We argue that one of the primary, but insufficient, motivating factors for suicide terrorism is strong religious belief. Evolutionary psychological theories related to religious belief, and supporting empirical work, are described, laying a foundation for examining suicide terrorism. Several promising (...) directions for future research on suicide terrorism from an evolutionary psychological perspective are highlighted, particularly within the theoretical framework of kin selection, and the implications of applying evolutionary psychology to suicide terrorism are discussed. (shrink)

The Mental Capacity Act received Royal Assent on 7 April 2005, and it will be implemented in 2007. The Act defines when someone lacks capacity and it supports people with limited decision-making ability to make as many decisions as possible for themselves. The Act lays down rules for substitute decision making. Someone taking decisions on behalf of the person lacking capacity must act in the best interests of the person concerned and choose the options least restrictive of his or her (...) rights and freedoms. Decision making will be allowed without any formal procedure unless specific provisions apply, such as a written advance decision, lasting powers of attorney or a decision by the court of protection. (shrink)

In this paper, we consider three arguments for the irrelevance of the doctrine of double effect in end-of-life decision making. The third argument is our own and, to that extent, we seek to defend it. The first argument is that end-of-life decisions do not in fact shorten lives and that therefore there is no need for the doctrine in justification of these decisions. We reject this argument; some end-of-life decisions clearly shorten lives. The second is that the doctrine of double (...) effect is not recognized in UK law ; therefore, clinicians cannot use it as the basis for justification of their decisions. Against this we suggest that while the doctrine might have dubious legal grounds, it could be of relevance in some ways, e.g. in marking the boundary between acceptable and unacceptable practice in relation to the clinician's duty to relieve pain and suffering. The third is that the doctrine is irrelevant because it requires there to be a bad effect that needs justification. This is not the case in end-of-life care for patients diagnosed as dying. Here, bringing about a satisfactory dying process for a patient is a good effect, not a bad one. What matters is that patients die without pain and suffering. This marks a crucial departure from the double-effect doctrine; if the patient's death is not a bad effect then the doctrine is clearly irrelevant. A diagnosis of dying allows clinicians to focus on good dying and not to worry about whether their intervention affects the time of death. For a patient diagnosed as dying, time of death is rarely important. In our conclusion we suggest that acceptance of our argument might be problematic for opponents of physician-assisted death. We suggest one way in which these opponents might argue for a distinction between such practice and palliative care; this relies on the double-effect doctrine's distinction between foresight and intention. (shrink)

McKay & Dennett's (M&D's) description of beliefs, and misbeliefs in particular, is a commendable contribution to the literature; but we argue that referring to beliefs as adaptive or maladaptive can cause conceptual confusion. “Adaptive” is inconsistently defined in the article, which adds to confusion and renders it difficult to evaluate the claims, particularly the possibility of “adaptive misbelief.”.

This study describes the theoretical assumptions and the application for health‐promoting conversations, as a communication tool for nurses when talking to patients and their families. The conversations can be used on a promotional, preventive and healing level when working with family‐focused nursing. They are based on a multiverse, salutogenetic, relational and reflecting approach, and acknowledge each person's experience as equally valid, and focus on families’ resources, and the relationship between the family and its environment. By posing reflective questions, reflection is (...) made possible for both the family and the nurses. Family members are invited to tell their story, and they can listen to and learn from each other. Nurses are challenged to build a co‐creating partnership with families in order to acknowledge them as experts on how to lead their lives and to use their own expert knowledge in order to facilitate new meanings to surface. In this way, family health can be enhanced. (shrink)

How democratic is contemporary Indonesia? While analysts differ, Indonesian citizens, when asked in systematic public opinion surveys conducted regularly by the authors since 1999, consistently express strong support for democratic principles and also believe that their country's democratic performance is high. Support for democratic performance is highly correlated with support for government performance, as measured by perceptions of the condition of the national economy and political system. At the same time, higher levels of education and income, in Indonesia as in (...) other countries, have created a considerable number of critical citizens, that is, citizens who value democracy but are critical of its performance. On our evidence for Indonesia, it is members of this group who are the most motivated and best prepared to demand a higher level of democratic performance from their elected officials. (shrink)

Stress in health care is affected by moral factors. When people are prevented from doing ‘good’ they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations (...) and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach’s alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: ‘internal demands’ and ‘external demands and restrictions’. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts. (shrink)

Dignity, usually considered an essential ethical value in healthcare, is a relatively complex, multifaceted concept. However, healthcare professionals often have only a vague idea of what it means to respect dignity when providing care, especially for persons with impaired autonomy. This article focuses on two concepts of dignity, human dignity and dignity of identity, and aims to analyse how these concepts can be applied in the care for persons with impaired autonomy and in furthering the practice of respect and protection (...) from harm. Three vignettes were designed to illustrate typical caring situations involving patients with mild to severely impaired autonomy, including patients with cognitive impairments. In situations like these, there is a risk of the patient’s dignity being disrespected and violated. The vignettes were then analysed with respect to the two concepts of dignity to find out whether this approach can illuminate what is at stake in these situations and to provide an understanding of which measures could safeguard the dignity of these patients. The analysis showed that there are profound ethical challenges in the daily care of persons with impaired autonomy. We suggest that these two concepts of human dignity could help guide healthcare professionals to develop practical skills in person-centred, ethically grounded care, where the patient’s wishes and needs are the starting point. (shrink)

Health care often involves ethically difficult situations that may disquiet the conscience. The purpose of this study was to develop a questionnaire for identifying various perceptions of conscience within a framework based on the literature and on explorative interviews about perceptions of conscience (Perceptions of Conscience Questionnaire). The questionnaire was tested on a sample of 444 registered nurses, enrolled nurses, nurses’ assistants and physicians. The data were analysed using principal component analysis to explore possible dimensions of perceptions of conscience. The (...) results showed six dimensions, found also in theory and empirical health care studies. Conscience was perceived as authority, a warning signal, demanding sensitivity, an asset, a burden and depending on culture. We conclude that the Perceptions of Conscience Questionnaire is valid for assessing some perceptions of conscience relevant to health care providers. (shrink)

The aim of this observational longitudinal cohort study was to describe relationships over time between degrees of stress of conscience, perceptions of conscience, burnout scores and assessments of person-centred climate and social support among healthcare personnel working in municipal care of older people. This study was performed among registered nurses and nurse assistants (n = 488). Data were collected on two occasions. Results show that perceiving one’s conscience as a burden, having feelings of emotional exhaustion and depersonalization and noticing disturbing (...) conflicts between co-workers were positively associated with stress of conscience. No significant changes were observed during the year under study, but degrees of stress of conscience and burnout scores were higher than in previous studies, suggesting that downsizing and increased workloads can negatively affect healthcare personnel. Following and expressing one’s conscience in one’s work, and perceiving social support from superiors are of importance in buffering the effects of stress of conscience. (shrink)

Fetal alcohol spectrum disorders is an umbrella term covering several conditions for which alcohol consumption during pregnancy is taken to play a causal role. The benefit of individuals being identified with a condition within FASD remains controversial. The objective of the present study was to identify ethical aspects and consequences of diagnostics, interventions, and family support in relation to FASD. Ethical aspects relating to diagnostics, interventions, and family support regarding FASD were compiled and discussed, drawing on a series of discussions (...) with experts in the field, published literature, and medical ethicists. Several advantages and disadvantages in regards of obtaining a diagnosis or description of the condition were identified. For instance, it provides an explanation and potential preparedness for not yet encountered difficulties, which may play an essential role in acquiring much needed help and support from health care, school, and the social services. There are no interventions specifically evaluated for FASD conditions, but training programs and family support for conditions with symptoms overlapping with FASD, e.g. ADHD, autism, and intellectual disability, are likely to be relevant. Stigmatization, blame, and guilt are potential downsides. There might also be unfortunate prioritization if individuals with equal needs are treated differently depending on whether or not they meet the criteria for a specific condition. The value for the concerned individuals of obtaining a FASD-related description of their condition – for instance, in terms of wellbeing – is not established. Nor is it established that allocating resources based on whether individuals fulfil FASD-related criteria is justified, compared to allocations directed to the most prominent specific needs. (shrink)

Although organizational and situational factors have been found to predict burnout, not everyone employed at the same workplace develops it, suggesting that becoming burnt out is a complex, multifaceted phenomenon. The aim of this study was to elucidate perceptions of conscience, stress of conscience, moral sensitivity, social support and resilience among two groups of health care personnel from the same workplaces, one group on sick leave owing to medically assessed burnout (n = 20) and one group who showed no indications (...) of burnout (n = 20). The results showed that higher levels of stress of conscience, a perception of conscience as a burden, having to deaden one’s conscience in order to keep working in health care and perceiving a lack of support characterized the burnout group. Lower levels of stress of conscience, looking on life with forbearance, a perception of conscience as an asset and perceiving support from organizations and those around them (social support) characterized the non-burnout group. (shrink)

In this article, we explore the organization of assistance in multilingual interaction in Swedish residential care. The data that form the basis for the study cover care encounters involving three residents with a language background other than Swedish, totalling 13 hours and 14 minutes of video documentation. The empirical data consists of a collection of 134 instances where residents seek assistance with the realization of a practical action. For this article, three examples that involve the manipulation of an object have (...) been selected for analysis. We use the concept of ‘recruitment’ to encompass the various methods by which assistance is sought in the care encounter. In the first example, the need for assistance concerns the transfer of an object that is recognizable and physically available for both participants. This, in combination with the resident’s gestural work that pinpoints the description of the action, facilitates its realization. In the second and third examples, the realization of the action becomes more difficult because the object involved is not recognizable for the caregiver. The article highlights the collaborative ways in which residents manage to support their talk through bodily practices, and the strong and empathetic engagement with which caregivers become involved in interpreting the meaning of these practices. Finally, we discuss the implications of our findings for care provision in multilingual circumstances. (shrink)

Concerning challenges with the social inclusion of children with special educational needs, it is imperative to evaluate teacher interventions that promote social inclusion. This study aimed to investigate the effects of cooperative learning intervention on social inclusion. In addition, it was investigated to what degree CL implementation affected the outcomes. Fifty-six teachers of 958 fifth-grade children were randomly selected to intervention and control groups upon recruitment to the study. The intervention teachers received training and coaching in CL and implemented this (...) approach three to four times a week for 15 weeks. The results showed a significant but small effect of CL on children’s social acceptance, but no significant effect on children’s friendships and perceptions of classroom relationships. The degree of CL implementation had effect on children’s social acceptance, but the effect was not consistent across social acceptance measures as a friend or a groupmate. Thus, it can be concluded that CL, conducted with the length and intensity of this study, may not lead to substantial changes in the social inclusion of children with SEN. In future studies, more focus needs to be devoted to teacher implementation of the CL approach. (shrink)