Routine HIV testing of hospital patients and pregnant women: informed consent in the real world

The Centers for Disease Control and Prevention (CDC) has recommended that HIV testing be routinely offered to certain patients in hospitals with a high prevalence of HIV infection and on all pregnant women. The CDC does not, however, offer implementation level guidelines for obtaining informed consent. We provide a moral justification for requiring informed consent for HIV testing and propose guidelines for securing such consent. In particular we argue that genuine informed consent can be secured without elaborate counseling, such as that currently used at Counseling and Testing Sites, provided that sufficient written notice is given to the patients before testing and that they are specifically asked for permission.     

The challenges of leadership in the modern world: introduction to the special issue

This article surveys contemporary trends in leadership theory as well as its current status and the social context that has shaped the contours of leadership studies. Emphasis is placed on the urgent need for collaboration among social-neuro-cognitive scientists in order to achieve an integrated theory, and the author points to promising leads for accomplishing this. He also asserts that the 4 major threats to world stability are a nuclear/biological catastrophe, a world-wide pandemic, tribalism, and the leadership of human institutions. Without exemplary leadership, solving the problems stemming from the first 3 threats will be impossible.     

Visual search in the real world: evidence for the formation of distractor representations

Visual search in the real world often requires that we search the same environment a number of times for different targets. What is the fate of information about fixated distractor objects during these searches? Here, participants searched the same array of real objects on a tabletop twice for two different targets successively whilst wearing a head-mounted eye-tracker. We found that fixating an object when it was a distractor in the first search facilitated search for that same object when it became the target in the second search. The results suggest that the location and identity of fixated distractor objects are represented to a level that guides subsequent searches, even when this information is not required at the time of fixation.     

Ecological interventions and the process of change for prevention: Wedding theory and research to implementation in real world settings

Considers a preventive intervention effort designed to modify the characteristics and regularities of the school environment so as to enhance the expectations conveyed to high risk students. Employing this case effort (Weinstein et al., 1991) as a base, several issues are highlighted that deserve greater attention in the design, implementation, assessment, and reporting of other preventively-focused social interventions. These issues include: (1) the degree of program implementation fidelity, (2) the impact a lack of attainment of program fidelity may have on arriving at erroneous evaluation conclusions about social programs, (3) the ways in which the theory and basic research employed in the program rationale is appropriate to and reflected in the program as designed, (4) issues of program potency and dosage, (5) the ways in which quantitative and qualitative evaluation data can enhance each other, and (6) the import of evaluability assessments of programs prior to moving to outcome evaluations. In addressing these issues, the importance of developmentally- and ecologically-informed program formulations is underscored. Finally, the critical role that program reports such as the Weinstein paper, with its careful discussion of both the process of implementation and outcome assessments, can play in the development of more effective prevention program implementation efforts is highlighted.     

Communicating in the real world: accounts from people who stammer

This qualitative study used in-depth interviews to explore the communicative experiences and coping strategies of 14 adults who stammer. Their accounts revealed that those participants with persistent developmental dysfluency felt that stammering had limited their lives especially in the areas of employment, education and self-esteem. All participants shared key styles of communicative management with avoidance and confrontation developing during childhood. The participants who had undertaken therapy during adulthood, relied upon a range of speech management techniques including self-evolved and therapeutic strategies. Many of the strategies regularly used by the respondents contributed to the limiting experience of stammering. This study highlights the experience of stammering on the individual, discusses the variety of strategies used to manage dysfluency and indicates the complexities of day-to-day communication. These findings are discussed in relation to speech and language therapy for adults who stammer.

Educational objectives: The reader will learn about and be able to give examples of: (1) the lived experience of stammering; (2) the communicative strategies used by adults; and (3) the situational management of stammering.     

Avian movements in a modern world: cognitive challenges

Different movement patterns have evolved as a response to predictable and unpredictable variation in the environment with migration being an adaptation to predictable environments, nomadism to unpredictable environments and partial migration to a mixture of predictable and unpredictable conditions. Along different movement patterns, different cognitive abilities have evolved which are reviewed and discussed in relation to an organism’s ability to respond to largely unpredictable environmental change due to climate and human-induced change, and linked to population trends. In brief, migrants have a combination of reliance on memory, low propensity to explore and high avoidance of environmental change that in combination with overall small brain sizes results in low flexibility to respond to unpredictable environmental change. In line with this, many migrants have negative population trends. In contrast, while nomads may use their memory to find suitable habitats, they can counteract negative effects of finding such habitats disturbed by large-scale exploratory movements and paying attention to environmental cues. They are also little avoidant of environmental change. Population trends are largely stable or increasing indicating their ability to cope with climate and human-induced change. Cognitive abilities in partial migrants are little investigated, but indicate attention to environmental cues coupled with high exploratory tendencies that allow them a flexible response to unpredictable environmental change. Indeed, their population trends are mainly stable or increasing. In conclusion, cognitive abilities have evolved in conjunction with different movement patterns and affect an organism’s ability to adapt to rapidly human-induced changes in the environment.     

Different routes to limited empathy in the sexes: Examining the links between the Dark Triad and empathy

A fundamental observation regarding the Dark Triad traits (i.e., narcissism, psychopathy, and Machiavellianism) is that they are all associated with limited empathy. However, little is known about these relationships beyond some basics. In this study (N = 352), we asked three questions. What is the nature of the relationship between the Dark Triad traits and empathy? Does limited empathy account for sex differences in the Dark Triad? Are men and women low on empathy through different personality traits? The Dark Triad traits were all related to low levels of empathy even when controlling for the shared variance among the traits. Empathy rates mediated sex differences in different aspects of the Dark Triad but not others. Low empathy rates were related to narcissism in women but psychopathy in men, suggesting different routes to limited empathy for men and women high on the Dark Triad.     

A demonstration of a token economy for the real world

Token economies are rarely used in real-world psychiatric settings because of barriers to their implementation, such an institutional constraints and insufficient collegial support. The line-level treatment team at Elgin Mental Health Center was able to overcome these contraints and develop a user-friendly token economy. This article describes Elgin's simple yet effective token economy and the process used to develop it.     

Biases in long-term location memory in the real world

The category adjustment (CA) approach to distortions in location memory has been largely documented in simplified lab-created spaces but minimally in navigable real-world environments. In the current paper, we extend the approach to a navigable real-world environment and specifically evaluate the assumption that long-term location memory may be retrievable despite errors in recall. Memory for the location of a fountain in a heavily navigated square on a university campus was tested by reproduction on a photograph of the square and then by a forced-choice recognition test. While the recall data showed the standard bias, the recognition data revealed chance-level performance. The pattern of results suggests a possible difference between accessibility of working memories for locations within laboratory-created spaces and long-term memories for locations within complex navigable spaces. The results are discussed in terms of the CA model.     

Spatial memory in the real world: long-term representations of everyday environments

When people learn an environment, they appear to establish a principle orientation just as they would determine the “top” of a novel object. Evidence for reference orientations has largely come from observations of orientation dependence in pointing judgments: Participants are most accurate when asked to recall the space from a particular orientation. However, these investigations have used highly constrained encoding in both time-scale and navigational goals, leaving open the possibility that larger spaces experienced during navigational learning depend on a different organizational scheme. To test this possibility, we asked undergraduates to perform judgments of relative direction on familiar landmarks around their well-learned campus. Participants showed clear evidence for a single reference orientation, generally aligned along salient axes defined by the buildings and paths. This result argues that representing space involves the establishment of a reference orientation, a requirement that endures over repeated exposures and extensive experience.