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Telephone and televideo have yielded equivalent patient satisfaction and psychosocial outcomes when compared to in-person genetic counseling, yet little is known about how they compare to one another. In this randomized controlled trial, veterans received genetic counseling via telephone or traveled to a clinic to participate via encrypted televideo. Knowledge and visit satisfaction were assessed 2 weeks later. Travel time, mileage, and out-of-pocket costs were calculated for videoconferencing. Qualitative interviews were conducted with patients and counselors to assess acceptability. Of the 20 male patients randomized to telephone, 90% received counseling and provided outcomes; of the 18 randomized to televideo, 67% received counseling and 50% provided outcomes. Telephone patients answered a mean of 4.4 of eight questions correctly at baseline and 4.7 at follow-up; televideo means were 5.6 and 6.5, respectively. Satisfaction was 25.2 out of 30 for telephone and 26.9 for televideo. Televideo patients incurred a median of 2.8 h of travel time, 40 roundtrip miles, and $67.29 in costs. Patients and counselors found both modes acceptable for providing education and answering questions. Although patients liked the flexibility of telephone, counselors felt patients missed more appointments and were distracted when using telephone. A noted advantage of videoconferencing was reading body language. Further evaluation of alternative delivery modes is needed.  相似文献   
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This article presents a discussion of the principle of extracortical organization of higher mental functions and its significance for the development of contemporary neuropsychology. The role of external factors (stimulus-mediator, symbol) in establishing functional connections between various brain systems is, in principle, universal. However, inasmuch as differing mediators and means, or significantly different details within them (direction of writing, orientation by maps or by the behavior of sea birds, etc.) may and in fact do develop in different cultures, neuropsychological analysis must take into account cross-cultural differences. Diagnostic tools must also be adapted to differing cultural contexts. The efficacy of this principle for the analysis of bilingual aphasia and of mental organization of speech, including the effect of acquisition of literacy in native language, is demonstrated. The importance of this principle for the development of new directions in applied neuropsychology is also discussed.  相似文献   
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Research on sleep loss and vigilance both focus on declines in cognitive performance, but theoretical accounts have developed largely in parallel in these two areas. In addition, computational instantiations of theoretical accounts are rare. The current work uses computational modeling to explore whether the same mechanisms can account for the effects of both sleep loss and time on task on performance. A classic task used in the sleep deprivation literature, the Psychomotor Vigilance Test (PVT), was extended from the typical 10‐min duration to 35 min, to make the task similar in duration to traditional vigilance tasks. A computational cognitive model demonstrated that the effects of time on task in the PVT were equivalent to those observed with sleep loss. Subsequently, the same mechanisms were applied to a more traditional vigilance task—the Mackworth Clock Task—providing a good fit to existing data. This supports the hypothesis that these different types of fatigue may produce functionally equivalent declines in performance.  相似文献   
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This paper explores the nomological network of workplace deviance by incorporating constructive deviance behavior. Constructive deviance focuses on behaviors that are intended to benefit the organization. In a series of three studies, a reliable and valid measure of constructive deviance behavior is developed. Individual and contextual‐level factors that facilitate constructive and destructive deviance are examined. The results suggest that while Machiavellianism is an important personality variable in predicting both constructive and destructive deviance, role breadth self‐efficacy is a central mechanism in understanding constructive but not destructive deviance. It was also found that access to information within the organization is a central contextual variable in eliciting both forms of deviance. Future research and implications are discussed.  相似文献   
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