Psychosocial adaptation in relatives of critically injured patients admitted to an intensive care unit

The aim of this study is to analyze how the length of time a patient spends in an Intensive Care Unit (ICU) affects close relatives, with regard to specific clinical variables of personality, family relationships and fear of death. The study group consisted of 57 relatives of seriously ill patients admitted to the ICU of "Virgen del Rocío" Rehabilitation and Trauma Hospital (Seville, Spain). The instruments applied were: a psychosocial questionnaire, clinical analysis questionnaire, family environment scale and fear of death scale. The relatives of patients admitted to ICU obtained higher scores in hypochondria, suicidal depression, agitation, anxious depression, guilt-resentment, paranoia, psychasthenia, psychological maladjustment and self-expression, and less in fear of their own death, as when compared to interviews with the same relatives 4 years later. The length of time a patient spent in the ICU influenced relatives in some clinical variables of personality, family relationships and fear of death     

Fitting Rasch model using appropriateness measure statistics

In this paper, the distributional properties and power rates of the Lz, Eci2z, and Eci4z statistics when they are used as item fit statistics were explored. The results were compared to t-transformation of Outfit and Infit mean square. Four sample sizes were selected: 100, 250, 500, and 1000 examinees. The abilities were uniform and normal with mean 0 and standard deviation 1, and uniform and normal with mean -1 and standard deviation 1. The pseudo-guessing parameter was fixed at .25. Two ranges of difficulty parameters were selected: +/- 1 logits and +/- 2 logits. Two test lengths were selected: 15 and 30 items. The results showed important differences between the T-infit, T-outfit, Lz, Eci2z, and Eci4z statistics. The T-oufit, T-infit, and Lz statistics showed poor standardization with estimated parameters because their distributional properties were not close to the expected values. However, the Eci2z and Eci4z statistics showed satisfactory standardization on all conditions. Further, the power rates of Eci2z and Eci4z were 5% to 10% higher than the power rates of Lz, T-outfit, and T-infit to detect items that do not fit Rasch model.     

Evaluation of a group cue-exposure treatment for opiate addicts

Twenty-four detoxified opiate addicts were randomized to an experimental group and a control group to evaluate efficacy of a group cue-exposure treatment to reduce or extinguish classically conditioned responses to drug-related stimuli. Assessment included psychophysiological responses (skin temperature, skin conductance level--SCL--, and heart rate) to a videotape and subjective measures (subjective craving, positive and negative affect) before and after the videotape. The experimental group received a group cue-exposure program to drug-related stimuli that comprised twelve treatment sessions administered three times weekly. The treatment program significantly reduced conditioned responses to drug-related stimuli, as measured by SCL and positive affect.     

Index of suspicion: feeling not believing

Throughout the U.S., state laws require professionals who work with children to report cases of suspected child abuse to child protection services. Both practically and conceptually, however, significant problems arise from a lack of clarity regarding the threshold that has been set for reporting. Specifically, there is no consensus as to what constitutes reasonable suspicion, and little direction for how mandated reporters should gauge their legal and professional responsibilities when they harbor suspicion. In this paper we outline the context of the problem, discuss the nature and scope of its conceptual underpinnings, and offer recommendations for moving towards a concrete, practical solution.     

The Five-factor Personality Inventory as a measure of the Five-factor Model: Belgian, American, and Hungarian comparisons with the NEO-PI-R

The lexically based Five-Factor Personality Inventory (FFPI) was correlated with the factors and facets of the Revised NEO Personality Inventory (NEO-PI-R) in Belgian (N = 265), American (N = 116), and Hungarian (N = 320) samples. Results were similar across the three cultures. Analysis of orthogonalized FFPI factors showed that three of them--emotional stability, extraversion, and agreeableness--showed a direct correspondence to their NEO-PI-R counterparts. Autonomy, however, was not clearly related to openness, and facet analysis suggested that it might be interpreted as a dominance factor Better matches to NEO-PI-R conscientiousness and openness could be obtained by using vectors rotated 30 degrees from the FFPI positions. Raw scale scores showed similar results. Researchers should not assume that all measures of the Five-Factor Model are qualitatively similar     

Senior capstone design and ethics: A bridge to the professional world

A senior level capstone design experience has been developed and offered with a particular emphasis on many of the professional issues raised in Accreditation Board for Engineering and Technology (ABET) Engineering Criterion IV. The course has sought to develop student awareness of the ethical foundation of the engineering profession, the global and societal framework within which engineers practice, and the environmental impact on engineering. The capstone design course also focused upon improving the technical communications skills of the graduating senior class with both extensive instruction in writing and multiple workshops dealing with the art of making an effective oral presentation. The effectiveness of the design course was assessed using Kirkpatrick’s model for evaluating training programs. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

Acquisition, learning, or development of language? Skinner's "Verbal Behavior" revisited

In 1957, Skinner, in his "Verbal Behavior", proposed an explanation on how a language is learned. In 1959, Chomsky strongly argued the non-learnability of language, establishing in the field of developmental psycholinguistics the substitution of the term "learning" for that of "acquisition". Currently, the constructivist models describe language acquisition as a process of ontogenetic, gradual, complex, and adaptive change. This new theoretical framework has been especially useful for rereading Verbal Behavior because it facilitates recovering the Skinnerian learning mechanisms. This can be observed in the recent research trends that recapture reinforcement and imitation (echoic responses), although they are now located in the initial phases of the process and are included in a cognitive dynamic that, by gradually increasing its complexity, can achieve grammar. The new constructivist theoretical framework, by retrieving the functional and referential aspects of language, can also take advantage of the classic Skinnerian proposal about the pragmatic types of verbal behavior, providing it with new meaning.     

Informed consent and the use of placebo in poland: Ethical and legal aspects

The concept of informed consent was one of the most fruitful ideas that deeply changed the relationships between physicians and their patients from paternalism to respect for the personal autonomy of subjects needing professional medical care. The great progress in medicine, also involving the pharmaceutical industry, has created an increasing need to perform different clinical and experimental trials. The evolution of clinical research in the last decades has influenced strongly the design of these studies. One of the most important changes in this field has been the use of placebo groups in double-blind controlled studies. The controversies have involved not only the use of placebo when standard or proven treatment was available, but also some specific problems concerning the procedure of obtaining informed consent in such trials. This paper briefly presents the evolution of informed consent in Poland as well as different ethical and legal problems concerning informed consent and the use of placebo controls in clinical trials. An earlier version of this paper was presented at an international conference, “Placebo: Its Action and Place in Health Research Today,” held in Warsaw, Poland on 12–13 April, 2003.