The doctor-patient relationship in the post-managed care era

The growth of managed care was accompanied by concern about the impact that changes in health care organization would have on the doctor-patient relationship (DPR). We now are in a "post-managed care era," where some of these changes in health care delivery have come to pass while others have not. A re-examination of the DPR in this setting suggests some surprising results. Rather than posing a new and unprecedented threat, managed care was simply the most recent of numerous strains on the DPR that have occurred throughout the century. These strains are a constant, inevitable consequence of the varying needs and concerns of patient and physicians as they seek to balance their desires for a certain type of DPR with their simultaneous desire for other aspects of care such as lower costs, greater technological sophistication, and improved outcomes.     

There must be a First: Why Thomas Aquinas Rejects Infinite,Essentially Ordered,Causal Series

Several of Thomas Aquinas's proofs for the existence of God rely on the claim that causal series cannot proceed in infinitum. I argue that Aquinas has good reason to hold this claim given his conception of causation. Because he holds that effects are ontologically dependent on their causes, he holds that the relevant causal series are wholly derivative: the later members of such series serve as causes only insofar as they have been caused by and are effects of the earlier members. Because the intermediate causes in such series possess causal powers only by deriving them from all the preceding causes, they need a first and non-derivative cause to serve as the source of their causal powers.     

Non-g residuals of the SAT and ACT predict specific abilities

This research examined whether non-g residuals of the SAT and ACT subtests, obtained after removing g, predicted specific abilities. Non-g residuals of the verbal and math subtests of the SAT and ACT were correlated with academic (verbal and math) and non-academic abilities (speed and shop), both based on the Armed Services Vocational Aptitude Battery. Non-g residuals of the SAT and ACT math subtests were positively related to math ability and negatively to verbal ability, whereas the opposite pattern was found for the verbal subtests. Non-g residuals of both sets of subtests were weakly related to non-academic abilities. The results support an investment theory of skills and abilities: Investing in skills in one area (e.g., math) improves abilities in that area but lowers abilities in competing areas (e.g., verbal).     

Individual differences in susceptibility to infection and illness following respiratory virus challenge

Abstract

The aim of the present research was to investigate whether susceptibility to experimentally-induced respiratory virus infections and illness is related to measures of personality, physiological state, performance efficiency, and subjective ratings of alertness and motivation obtained prior to virus challenge. Two studies, using different viruses, showed that volunteers who subsequently developed colds had higher temperatures prior to virus challenge than those who remained free from illness. Similarly, those who later had colds were worse than other volunteers on certain performance tests given in the pre-challenge period. The results also showed that task-related motivation was related to subsequent infection. Personality scores were poor predictors of infection and illness, the only exception being introversion, which, in one study, was related to the likelihood of developing a sub-clinical infection.     

Interpersonal constructs and communicative ability in a police environment: A preliminary investigation

Abstract

This study investigates the relation between indexes of the development of interpersonal construct systems and the qualities of messages generated in response to persuasive tasks within the context of an urban police force. Hypotheses assuming that length of service as a line officer would predict less developed construct systems, and that more developed construct systems would predict message strategies that acknowledge the unique qualities of receivers found general support. In addition, the possibility of further relations between length of service and message variables was explored, but no substantial evidence was found for such effects. These results show the importance of environmental influences on construct development, and suggest that interpersonal perception and message behavior functionally adapt to the needs of organizational participation.     

Does intra-individual change predict offender recidivism? Searching for the Holy Grail in assessing offender change

Offender rehabilitation effectively reduces recidivism for treatment groups compared to control groups, but there is less evidence demonstrating that intra-individual changes are related to reductions in risk. We review and critique academic and government literature linking individual change scores to recidivism, focusing on three key treatment domains: cognition, violence, and substance misuse. Database searches identified 378 studies measuring change, but only 53 studies yielding 49 explicit tests of the relationship between intra-individual change scores and recidivism outcome. Of the 49 available tests, 26 effect sizes (53.1%) were significant, ranging from small (d = 0.06) to large (d = 1.48). Across all domains, change variables significantly related to recidivism included known dynamic risk factors: antisocial attitudes, antisocial beliefs, antisocial associates, antisocial personality, social support, and substance misuse. Two additional findings centered on changes in negative emotion and successful treatment process. This review further suggests there is a need to utilize better measurement strategies and more sophisticated constructs. Additional practical, theoretical, and methodological implications are discussed.