Clergy ethics in a changing society: mapping the terrain

Reviewed Book: Wind, James P. Clergy ethics in a changing society: mapping the terrain. Louisville, Ky: Westminster/John Knox Press, 1991

Leadership in Ethical Families

In this paper I have been asked to respond to two papers presented at an earlier conference. Both deal with the ethics of leadership in families. The first paper, by Rachel Xiaohong Zhu from the People’s Republic of China, reviews the concept of family relationships and duties in the Confucian tradition and compares that with the changes going on in China today as a consequence of westernisation and modernisation and also as a consequence of China’s one child policy.1 The second paper is by Richard Ondji’i Toung from Cameroon. 2 He reviews the concept of the family, as is understood by the Fang people of southern Cameroon. He is particularly concerned with the breakdown of assumptions about how traditional leadership roles should be carried out and what resources Christianity may have to offer in this situation. Both papers pay very close attention to the questions that emerge from their geographic and cultural context and both take for granted that families are biological. I want to respond by paying close attention to my context and the questions that emerge there. I am a Canadian academic theologian with special expertise in Christian social ethics, specifically ethics and economics, born of English and American immigrant parents. I am a lay Anglican, who worked for almost 20 years for the United Church of Canada, a 20th century denomination formed from the Congregational, Methodist and Presbyterian traditions

Conversation Repair and Acquired Hearing Impairment: A Preliminary Quantitative Clinical Study

"Article Copyright 2004 The Authors." "Published edition Copyright 2004 Australian Academic Press. Published version of the paper reproduced here with permission from the publisher."This report provides a quantitative summary of the initial findings in a series of investigations into the validity and reliability of repair behaviour recorded in free conversation in clinical settings between adults who have acquired hearing impairments (HIs) and their frequent communication partners (FCPs). Seven adults who have severe or greater acquired HIs (and who had subsequently been either fitted with hearing aids or undergone cochlear implanta-tion) were audio-recorded undertaking a 20-minute free conversation in a quiet clinical setting with their chosen FCP. Transcriptions of the conversations were analysed for the occurrence of repair sequences following the Conversation Analysis (CA) model. A total of 735 completed repair sequences were identi-fied across the seven conversations, the majority occurring within the same turn as the trouble source. No difference was noted in the frequency with which all but one trajectory was initiated by either the HI or FCP participants. Repairs initiated by the HI participant and repaired by the FCP in response to a trouble source in a previous turn by the FCP occurred significantly more often than the same sequence initiated by the FCPs. The results empha-sise the usefulness of framing repair activity arising from acquired HI in the broader conversational act of repairing and the CA model

Conversation Analysis of Repair in Interaction with Adults who Have Acquired HI

“Copyright 2009, Sonova. Published version of the paper reproduced here with permission from the publisher."This chapter presents a summary of some recent re-search which has been undertaken to address the pat-terns of conversational behaviour in interaction involv-ing adults who have post-lingual hearing impairment (HI). The purpose behind this research is to develop a clinical assessment and intervention protocol for assist-ing HI adults and their conversation partners in reduc-ing the impact of conversation breakdown and its repair in everyday talk. Lind (this volume) lists various conversational be-haviours which arise in the conversation of HI adults and which have been identified by the authors as being mal-adaptive . Each of these behaviours may evolve to be a genuine target for intervention. However, at this point, the patterns of most of these behaviours as they are in-fluenced by one person’s HI are not yet well enough un-derstood nor are they yet clearly distinguished from the same behaviours as they occur in conversations not in-fluenced by HI. Until evidence of their patterns of occur-rence and their sequential consequences is established they cannot readily be translated into goals for assess-ment or intervention. Amongst these behaviours, conversation repair has been the most commonly identified therapy target, for two reasons. First, it is the only one of these behaviours that can be identified a priori as a problem for conversa-tional fluency. Repair is by its very nature the result of a breakdown in mutual understanding in the conversa-tion. Participants’ attempts to resolve the breakdown inhe immediate environment in which it occurred speaks to the importance to the talkers of re-instating mutual understanding. Second, there is now a growing body of research that identifies the patterns of repair as they may be influenced by post-lingual HI. The common se-quential behaviours in one particular type of repair were outlined briefly in Lind (this volume). Two additional ex-amples are provided here also. This series of projects from our recent research has been designed as the early stages in an attempt to ad-dress the foundation issues in conversation-based ther-apy; a model of therapy in which clinical tasks directly address conversation difficulties arising as a result of one participant having a post-lingual hearing impair-ment. The studies have been designed to address key questions about the clinical patterns of repair behaviour, including: • Can we reliably sample conversation repair? • Is repair behaviour consistent over time? • Is repair influenced by intervention? and • Does repair in conversationally-oriented clinical tasks mirror repair in conversation sampling

Hearing handicap and quality of life: Reports by cochlear implantees and their frequent communication partners

“Copyright 2001, Speech Pathology Association of Australia Ltd (https://www.speechpathologyaustralia.org.au/) . Published version of the paper reproduced here with permission from the publisher.”Questionnaires concerning communication, hearing handicap and quality of life were posted to all 55 adult cochlear implantees known to be resident in South Australia. Parallel questionnaires were included for completion by a chosen frequent communication partner. This interim analysis focuses on replies from 34/55 (61.8%) of recipients currently received on two scales included in the questionnnaire; the Hearing Handicap Inventory for the Elderly (HHIE - Ventry & Weinstein, 1982), and the SF-36 (Ware, Snow, Kosinski & Gandek, 1993). The main results indicate that: (a) implantees and their frequent communication partners substantially agree in their assessment of the hearing handicap remaining post-implantation, and (b) implantees’ ratings of aspects of quality of life are similar to those of the general population in South Australia. These results indicate both the complimentary and confirmatory nature of these two scales. Implications for assessment and intervention for this population are discussed in light of these findings

Attendees’ Perceptions of, Motivation for and Outcomes, Following an Adult Group Aural Rehabilitation Program

"Article Copyright 2012 The Authors." "Published edition Copyright 2012 Australian Academic Press. Published version of the paper reproduced here with permission from the publisher."The aim of this grounded theory (GT) study was to gain insight into adult participants’ perceptions of a group aural rehabilitation (AR) program. The partici-pant group for this in-depth interview-based study were 8 female and 2 male adults with acquired hearing losses who had completed an introductory group AR course conducted by South Australian organisation Hearing Solutions (now Guide Dogs of South Australia and Northern Territory Hearing Services) in the prior 12 months. Semistructured interviews were carried out and analysed using GT methodology. The core category (Empowerment through improved self-image) describes the overall main benefit the partici-pants reported from attending the course. Six descriptive categories were found that underpinned the core category: Improved understanding of communication strategies, Improved social relation-ships, Course satisfaction, Personal validation from social interaction, Decreased emotional isolation, and Improved self-confidence. An additional three descriptive categories were discovered that related to factors that motivated people to attend the course: Motivation for change, Hearing difficulties, and Negative self-perceptions of hearing loss. The current study provides a model for understanding how these factors may interrelate, and highlights the importance of motivation and group interaction in obtaining positive outcomes in A

Adults’ Perceptions of Their Tinnitus and a Tinnitus Information Service

"Article Copyright 2010 The Authors." "Published edition Copyright 2010 Australian Academic Press. Published version of the paper reproduced here with permission from the publisher."The South Australian Government funds Tinnitus SA to provide advice and information to South Australians to assist in their understanding of tinni-tus and their decision making about tinnitus-related service provision. This qualitative study aimed to identify key motivations for adults seeking tinnitus advice, determine how those services are perceived, and provide insight into the help-seeking behaviour of those who experience tinni-tus. Participants in this study were recruited from Tinnitus SA’s attendance lists for their community information sessions held in 2008 and 2009. Of the 60 people contacted, 13 adults agreed to particpate in the semistructured interviews. Interviews, lasting approximately 45 minutes focused on interviewees’ perceptions of their tinnitus prior to attending the Tinnitus SA information session, their response to the information session itself, and their perceptions and actions following the information session. Grounded theory was used as the guiding method-ology for analysis of the transcribed interview data. The themes that emerged during analysis of the interviews fell into two broad descriptive categories: Empowerment through information and education; and If you can’t cure me I’ll cope. Together these categories led to the overarching theme of participants’ responses: ‘I don’t need help, but I’d like more information’. Further analy-sis revealed that the Tinnitus SA community sessions were the primary source of information for the majority of these participants and there was a high level of satisfaction with these sessions by contrast to other information sources

Defining the border of the subthalamic nucleus for deep brain stimulation: A proposed model using the symmetrical sigmoid curve function

Background: The subthalamic nucleus (STN) is an important target during deep brain stimulation (DBS). Accurate lead placement is integral to achieving satisfactory clinical outcomes; however, the STN remains a structure whose visualization is highly variable with borders often difficult to define. We aimed to develop an objective method of evaluating the visibility of the STN on preoperative magnetic resonance imaging (MRI) to standardize future comparative assessments between imaging protocols and patient-specific parameters. Methods: An imaging study of 64 prospectively collected patients undergoing bilateral DBS of the STN for various movement disorders was performed with institutional approval. MRI scans were acquired using a uniform protocol involving general anesthesia, cranial fixation in a Leksell stereotactic frame, and long acquisition times using a 3T MRI scanner. The images were analyzed using the iPlan Stereotaxy, version 2.6, workstation. High-resolution T2-weighted axial sections were evaluated, and the voxel values in the region of the presumed posterior border of the STN (as defined by the operating neurosurgeon) were obtained. A 4-parameter logistic symmetrical sigmoid curve was used to map the voxel values as they progressed from within to outside the region of the STN border. The inflection point and Hill coefficient of this symmetrical curve was calculated to provide objective information on the location and clarity of the STN border, respectively. These findings were compared with the surgeon\u27s judgment of the STN border. To demonstrate the use of the sigmoid curve, the patients\u27 head volumes were also calculated and evaluated to assess whether larger head volumes adversely affected STN visibility. Results: The symmetrical sigmoid curve model provided objective information on the visibility of the STN on T2-weighted MRI scans and could be generated in 86% of the patients. The other 14% of patients had MRI scans that generated linear graphs, indicating the poorest scoring for STN image quality. No correlation between head volume and STN visibility was identified. Conclusions: Our proposed statistical model allows for standardized examination of the visibility of the STN border for DBS and has potential for both clinical and academic applications

Intraoperative detection of blood vessels with an imaging needle during neurosurgery in humans

Intracranial hemorrhage can be a devastating complication associated with needle biopsies of the brain. Hemorrhage can occur to vessels located adjacent to the biopsy needle as tissue is aspirated into the needle and removed. No intraoperative technology exists to reliably identify blood vessels that are at risk of damage. To address this problem, we developed an “imaging needle” that can visualize nearby blood vessels in real time. The imaging needle contains a miniaturized optical coherence tomography probe that allows differentiation of blood flow and tissue. In 11 patients, we were able to intraoperatively detect blood vessels (diameter, \u3e500 μm) with a sensitivity of 91.2% and a specificity of 97.7%. This is the first reported use of an optical coherence tomography needle probe in human brain in vivo. These results suggest that imaging needles may serve as a valuable tool in a range of neurosurgical needle interventions

Using relationships as a tool: early childhood educators’ perspectives of the child–caregiver relationship in a childcare setting

Children's early years are critical for development and many children access out-of-home care during this time. Services offering high-quality childcare afford an opportunity to impact positively on children's development, including acquisition of communication skills. A strong, responsive relationship between child and carer is important in facilitating children's communication development. For infants who are not yet verbal, early childhood educators (ECEs) need to be highly sensitive to the child's communication, and they need to develop a relationship with the child to interpret their signals and facilitate their communication. This study investigated the perspectives of ECEs on their relationships with infants in their care. Individual semi-structured interviews with ECEs were conducted and the interview data were triangulated with videoed observational data. The results demonstrate that these ECEs use the relationship with the children in their care as a tool for provision of optimal learning experiences across multiple developmental domains