Physicians, Patients, and Medical Dialogue in the NYPD Blue Prostate Cancer Story

Extending literature on health information to entertainment television, we analyze the prostate cancer narrative presented in the police drama, NYPD Blue. We explain how the physician-patient interaction depicted on the show followed (and sometimes did not follow) the medical dialogue model. Findings reveal that the producers of this show advocate a more dialogic model of medical interaction. Portrayals of incompetent, ineffective physicians are contrasted with the superior, effective efforts of other physicians. The audience learns that a non-dialogic approach characterizes "bad doctors," while the dialogic method typifies "good doctors." Likewise, medical professionals can use such texts to enhance physician-patient interaction.     

Perceived object trajectories during occlusion constrain visual statistical learning

Visual statistical learning of shape sequences was examined in the context of occluded object trajectories. In a learning phase, participants viewed a sequence of moving shapes whose trajectories and speed profiles elicited either a bouncing or a streaming percept: the sequences consisted of a shape moving toward and then passing behind an occluder, after which two different shapes emerged from behind the occluder. At issue was whether statistical learning linked both object transitions equally, or whether the percept of either bouncing or streaming constrained the association between pre- and postocclusion objects. In familiarity judgments following the learning, participants reliably selected the shape pair that conformed to the bouncing or streaming bias that was present during the learning phase. A follow-up experiment demonstrated that differential eye movements could not account for this finding. These results suggest that sequential statistical learning is constrained by the spatiotemporal perceptual biases that bind two shapes moving through occlusion, and that this constraint thus reduces the computational complexity of visual statistical learning.     

Mindless decision making and environmental issues: gestalt/feature-intensive processing and contextual reasoning in environmental decisions

In the absence of relevant information in working memory during decision consideration, respondents tend to rely on a style of cognitive processing that may result in premature or inaccurate decision making (M. J. Sharps, 2003). M. J. Sharps and S. S. Martin (2002) demonstrated this effect in executive decision making. In the present study, the authors extended these methods to decisions about environmental issues. Respondents rated decisions about issues such as overpopulation, energy policy, and food production in the presence or absence of simple pertinent information. The presence of such information in the immediate context of environmental decisions, and therefore in working memory, significantly improved respondents' ability to understand negative decision consequences. These results demonstrate the importance of contextual information in environmental decision making.     

Iterating between lessons on concepts and procedures can improve mathematics knowledge

Background Knowledge of concepts and procedures seems to develop in an iterative fashion, with increases in one type of knowledge leading to increases in the other type of knowledge. This suggests that iterating between lessons on concepts and procedures may improve learning. Aims The purpose of the current study was to evaluate the instructional benefits of an iterative lesson sequence compared to a concepts‐before‐procedures sequence for students learning decimal place‐value concepts and arithmetic procedures. Samples In two classroom experiments, sixth‐grade students from two schools participated (N = 77 and 26). Method Students completed six decimal lessons on an intelligent‐tutoring systems. In the iterative condition, lessons cycled between concept and procedure lessons. In the concepts‐first condition, all concept lessons were presented before introducing the procedure lessons. Results In both experiments, students in the iterative condition gained more knowledge of arithmetic procedures, including ability to transfer the procedures to problems with novel features. Knowledge of concepts was fairly comparable across conditions. Finally, pre‐test knowledge of one type predicted gains in knowledge of the other type across experiments. Conclusions An iterative sequencing of lessons seems to facilitate learning and transfer, particularly of mathematical procedures. The findings support an iterative perspective for the development of knowledge of concepts and procedures.     

Development and Initial Validation of an Abbreviated Spider Phobia Questionnaire Using Item Response Theory

An abbreviated Spider Phobia Questionnaire (SPQ) was developed using methods based in item response theory. Fifteen of the 31 SPQ items that demonstrated good to excellent discrimination along the spider fear continuum were retained in Study 1 that consisted of 1,555 nonclinical and clinical participants. The SPQ-15 demonstrated good internal consistency and correlated highly with the full SPQ. Structural equation modeling revealed that the SPQ-15 demonstrated excellent convergent validity, with strong associations with small animal disgust and other phobic symptoms. Supportive evidence was also found for divergent validity in relation to panic-related symptoms. The SPQ-15 was uniquely predictive of avoidance behavior and fear and disgust responding towards spiders in nonclinical, analogue, and treatment-seeking samples in Studies 2, 3, and 4. Lastly, in Study 5, the SPQ-15 was sensitive to the effects of exposure-based treatment. These findings suggest that the SPQ-15 has considerable strengths, including decreased assessment and scoring time while retaining high reliability, validity, and sensitivity.     

Relationship Between Sensory Deficits and Externalizing Behaviors in an Urban, Latino Preschool Population

This study examined the relationship between sensory deficits and externalizing behavior problems in preschool children. Parents of 179 urban, Latino preschool children completed two parent-report measures, the Short Sensory Profile (SSP), as a checklist for sensory symptoms, and the Achenbach Checklist for Ages 1½–5 (CBCL/1½–5) to assess externalizing behavior problems. Measures were available in Spanish or English depending on the parent’s preference. Correlations were performed between the total sensory deficits scale of the SSP and the Oppositional Defiant Disorder, Attention Deficit Hyperactivity Disorder, and Externalizing Problems scales of the CBCL. Significant correlations were found between increasing levels of sensory deficits and increasing externalizing behavior problems. Correlations were also examined in subcategories of age, gender and socioeconomic status. Five-year-old children showed stronger correlations than 4-year-old children, while males showed stronger correlations than females, and the highest correlations were found in children of families reporting between $18,001 and $24,000 per year annual income. Findings suggest that Latino preschool children with externalizing behavior problems may suffer from delays in sensory development that impact their behavior. Clinical interventions should promote strategies that either reduce or increase environmental stimuli in accordance with the sensory abilities of the individual child.     

Electrophysiological responses to auditory novelty in temperamentally different 9‐month‐old infants

Behavioral reactivity to novel stimuli in the first half‐year of life has been identified as a key aspect of early temperament and a significant precursor of approach and withdrawal tendencies to novelty in later infancy and early childhood. The current study examines the neural signatures of reactivity to novel auditory stimuli in 9‐month‐old infants in relation to prior temperamental reactivity. On the basis of the assessment of behavioral reactivity scores at 4 months of age, infants were classified into groups of high negatively reactive and high positively reactive infants. Along with an unselected control group, these groups of temperamentally different infants were given a three‐stimulus auditory oddball task at 9 months of age which employed frequent standard and infrequent deviant tones as well as a set of complex novel sounds. In comparison to high positively reactive and control infants, high negatively reactive infants displayed increased amplitude of a positive slow wave in the ERP response to deviant tones compared to standard tones. In contrast, high positively reactive infants showed a larger novelty P3 to the complex novel sounds. Results are discussed in terms of optimal levels of novelty for temperamentally different infants.     

Making treatment effect inferences from multiple-baseline data: The utility of multilevel modeling approaches

Multiple-baseline studies are prevalent in behavioral research, but questions remain about how to best analyze the resulting data. Monte Carlo methods were used to examine the utility of multilevel models for multiplebaseline data under conditions that varied in the number of participants, number of repeated observations per participant, variance in baseline levels, variance in treatment effects, and amount of autocorrelation in the Level 1 errors. Interval estimates of the average treatment effect were examined for two specifications of the Level 1 error structure (σ² I and first-order autoregressive) and for five different methods of estimating the degrees of freedom (containment, residual, between—within, Satterthwaite, and Kenward—Roger). When the Satterthwaite or Kenward—Roger method was used and an autoregressive Level 1 error structure was specified, the interval estimates of the average treatment effect were relatively accurate. Conversely, the interval estimates of the treatment effect variance were inaccurate, and the corresponding point estimates were biased.     

Rethinking paradigms in geriatric ethics

This paper calls for a shift away from autonomy as the central value in geriatric ethics. In treatment and experimental settings, differences between older and younger adults are easily attributed to deficiencies on the part of the elderly when autonomy is the central value. Overemphasis on the concept of autonomy skews our understanding of human relationships toward excessively rational models, distracts attention from important physical and social characteristics of aged persons, and results in ethics by default. This paper describes several principles that would be more useful starting points than autonomy in developing a geriatric ethic.