Jewish medical ethics in the care of the cancer patient

The care of the patient with cancer requires the development not only of a medical plan, but an ethical plan as well. This plan should integrate the physician's and the patient's perceptions of medical and ethical propriety. Jewish biomedical ethical principles are based on the teaching of the Old Testament and its various interpretations. In this paper, I discuss how these principles can be used to help guide the physician caring for the patient with cancer. Other ethical systems could be applied in a similar fashion.     

Efficient pain assessment in clinical settings.

The need for efficient and practical assessment techniques of the multidimensional nature of chronic pain remains paramount in clinical settings. Visual analogue scales (VASs) and simple behavioral observation methods have been proposed as efficient, reliable, and valid measures of the subjective (sensory and affective) and overt behavioral aspects of the pain experience. The relationships among VASs and the UAB Pain Behavior Scale were examined among 48 chronic pain patients. Ratings of overt behavior were significantly related to both the VAS sensory and VAS affective ratings. Regression analysis indicated that the VAS scores accounted for significant amount of the variance (27.7%) in UAB scores. Moreover, the affective dimension of self-reported pain tended to be more strongly related to the visible manifestations of pain than were ratings of pain intensity.     

Parent-tutoring procedures: Experimental analysis and validation of generalization in oral reading across passages,settings, and time

A study that involved parents as reading tutors was carried out at home during the summer with four elementary children, three with learning disabilities. One purpose was to determine the effects of tutoring in the basal reader on reading rates at home. Another purpose was to determine potential generalization effects as a result of parent tutoring on different academic tasks at home and, later at school, on different and similar tasks. A combination multiple-baseline and reversal design tested for replication and generalization effects. Increases in correct rates were noted for the targeted variables across conditions. The results indicated that parents tutoring with school basal texts during the summer produced marked increases in reading rates that generalized at home to different academic tasks and at school to different and similar tasks. This suggests that parents, when using specific tutoring procedures, can increase their children's academic skills.     

An introduction to organic brain syndromes

Organic brain syndromes are of forensic interest for several reasons. First, patients with organic brain syndromes may require judicial determination of competence in any of a number of areas, e.g., testamentary capacity, need for financial guardianship, or competence to make medical decisions. Second, any patient whose mental state is of legal interest will need evaluation for contributing organic factors; uncovering these factors may have considerable medical and legal consequence. Third, the discovery of organic factors may be decisive in the outcome of a judicial proceeding, where “hard” biological data are often accorded more weight, and are thus more persuasive, than “soft” psychological data. This article provides an introductory overview of the organic brain syndromes. For each syndrome, the clinical features are described and are illustrated with a case vignette, the more common etiologies are presented, and selected aspects to the evaluation are highlighted. In addition, since the detectian of malingered mental illness is a key component in many forensic contexts, characteristics are described which help to distinguish actual from malingered mental illness.     

Process parallels in related groups

The theoretical basis for the repetition of themes in related groups is addressed by describing similar processes in four systems: inpatient psychiatric ward, inpatient psychotherapy group, supervisory group, and group psychotherapy division. The principles of general system theory help explain process parallels in allied groups and illuminate group process.     

Common response processing and psychological refractoriness

This experiment examined whether structural considerations, that is the functional closeness of limb control centres (Kinsbourne and Hicks 1978), have a role to play in common processing models of psychological refractoriness. A typical double stimulation paradigm was used (Kantowitz 1974). On experimental trials, subjects responded with the right hand (RT1) to an auditory signal (0.80 probability). After a varied interstimulus interval (ISI) of 100, 200, 300 or 700 msec, one of three lights corresponding to one of the other limbs provided the signal for the second response (RT2). Control trials for RT1 and RT2 involved both stimuli, but subjects were required to make only one response. Results indicated that experimental RT1 was lengthened considerably over control values. While typical double stimulation effects were found at short ISIs, that is RT2 was lengthened, RT2 at long ISIs was actually faster than double stimulation control values. Although the RT results were not in a pattern that would be predicted by functional distance (Kinsbourne and Hicks 1978), within subject correlations of RT1 and RT2 by limb condition suggest that structural considerations may have a role to play. While within subject correlations were positive at all levels of ISI, they decreased as the interval between the two signals increased. The implications of these results for common processing models are discussed.