Non-heart-beating organ donation: a reply to Campbell and Weber.

In the preceding commentary, Campbell and Weber raise two valid and important issues concerning non-heart-beating organ donation (NHBOD). First, because the procedure links withdrawal of life support and the potential for subsequent organ donation, the desire for organs may create a situation in which care of the dying individual has relatively less importance and the dying may receive suboptimal care. Second, even if concerns about care of the dying were dealt with adequately, there will not be enough non-heart-beating donors to significantly decrease the organ shortage that exists, making the procedure not worth the risk. We agree that attention to the important details of caring for the dying are, and must be, the primary concern of all health care workers caring for those individuals. Ensuring the patients' comfort, dignity, and autonomy, and providing for family and social support are the mainstays of this care. All policies for NHBOD should clearly support and mandate these concepts. Regarding the second concern, we agree that NHBOD is currently rare; however, evidence is increasing that this type of donation has great potential. Continued growth of the practice in this country will depend largely on public acceptance, which we believe will be directly influenced by whether the public perceives that care of the dying is not compromised by this procedure.     

Heterosexual Therapists Leading Lesbian and Gay Therapy Groups: Therapeutic and Political Realities

The authors describe the thought processes, plans, and reflections of two heterosexual therapists who decided to lead gay and lesbian therapy groups in a university counseling center. The debate regarding the viability of the heterosexual counselor and the gay and lesbian client pair is discussed, as are the practical issues informing and maintaining thegroups. Campus political issues regarding the groups and counselor homophobia are explored.     

Organizational and extraorganizational factors affecting stress,employee well-being,and absenteeism for males and females

The purpose of this research is to examine separately for males and females, the effects of different sources of job and life stress on the emotional and physical well-being of those individuals, and in turn on absenteeism. Results using a sample of 170 males and 204 females indicated that females experienced higher levels of job stress, absenteeism, and poorer emotional well-being. Patterns of relationships for males and females were similar, however, the data suggest that sex moderates the effects of different sources of stress on emotional and physical well-being and absenteeism. The model developed as a part of this research was more complicated for females than for males.     

Object recognition contributions to figure-ground organization: Operations on outlines and subjective contours

In previous research, replicated here, we found that some object recognition processes influence figure-ground organization. We have proposed that these object recognition processes operate on edges (or contours)detected early in visual processing, rather than on regions. Consistent with this proposal, influences from object recognition on figure-ground organization were previously observed in both pictures and stereograms depicting regions of different luminance, but not in randomdot stereograms, where edges arise late in processing (Peterson & Gibson, 1993). In the present experiments, we examined whether or not two other types of contours—outlines and subjective contours—enable object recognition influences on figure-ground organization. For both types of contours we observed a pattern of effects similar to that originally obtained with luminance edges. The results of these experiments are valuable for distinguishing between alternative views of the mechanisms mediating object recognition influences on figure-ground organization. In addition, in both Experiments 1 and 2, fixated regions were seen as figure longer than nonfixated regions, suggesting that fixation location must be included among the variables relevant to figure-ground organization.     

Personal advertisements of male-to-female transsexuals,homosexual men,and heterosexuals

Transsexuals, because of their attempts at gender reversal, offer a unique opportunity to study self-presentation, social roles, and stereotypes. The present study is a content analysis of personal advertisements of male-to-female transsexuals (TM, N =99), homosexual (HoM, N =64) and heterosexual men (HM, N =99), and heterosexual women (HW, N =99). Advertisements were coded for the presence or absence of 11 characteristics either offered or sought, based on the 1984 work of Deaux and Hanna. The content of TM personal advertisements was significantly different from those of HW, HM, or HoM. TM mentioned physical characteristics and sincerity, and requested friendship most often; HoM mentioned sexuality most often; HM offered financial security and status in the form of occupation, and listed marital status most often; and HW offered personality characteristics and attractiveness most often. Several factors may contribute to the pattern of differences observed, including the fact that TM were more likely to be seeking friendship than sexual partners, in contrast to the other three groups.     

Counseling and screening for cystic fibrosis in patients with congenital bilateral absence of the vas deferens: Patient perceptions

Congenital bilateral absence of the vas deferens (CBAVD) occurs in approximately 1.3% of infertile males and is thought to be, in most cases, a primarily genital form of cystic fibrosis (CF). Fourteen males with CBAVD considering microsurgical sperm aspiration from the epididymis (MESA) and in vitro fertilization were seen for genetic counseling and screening for CF. To retrospectively evaluate these patients' perceptions of the counseling and screening information, we conducted structured telephone interviews to assess their recall of information about CF and its impact on their health concerns and reproductive plans. We found that, as the health implications of CF are abstract and not as important to patients as the diagnosis of CBAVD itself, patients tend to view their CF status primarily in terms of their reproductive potential. Retrospective analysis afforded us an opportunity to identify the psychosocial issues of most concern to this unique patient population.     

The psychologist's role in assessing and facilitating patients' knowledge of advance directives in medical settings: A preliminary investigation

In a time of budgetary shortfalls in the medical industry, an aging population, and an increased emphasis on health care choices, psychologists are being called upon to administer advance medical directive programs to patients. This study reports preliminary findings from a program to assess and facilitate patients' knowledge of advance directives (ADs) by the Psychology Service at the Ann Arbor VA Medical Center. The participant pool included 243 male veteran patients admitted to medical and surgical wards at the hospital. The intervention included the use of a computer-generated prompt for consultation, which was sent to the psychology staff in response to a patient inquiry regarding ADs. It also involved an increased emphasis on the delivery of written material on ADs by the admissions clerks. The intervention appeared to result in a modest increase in patients' knowledge of advance directives. Suggestions are offered for areas that should be emphasized in future attempts to increase patients' knowledge and utilization of advance directives.     

A form of behaviour therapy for some states diagnosed as “affective disorder”

Certain of the states commonly diagnosed by psychiatrists as “affective disorder” do not respond favourably to the usual treatments prescribed, and it is argued by Lum (1976) that such states are not appropriately labelled, as they are primarily due to the somatic condition of hypocapnoea—an abnormally low level of arterial carbon dioxide. This condition is well-recognized and can be diagnosed by appropriate physiological investigation. Hypocapnoea seriously affects various somatic systems, and if the patient later experiences affective distress it is a secondary symptom due to a vicious circle mediated by autonomic responses. The treatment of choice is a form of behaviour therapy aimed at altering the breathing response in the direction of building up toleration of a higher habitual level of arterial carbon dioxide. Existing work by behaviour therapists and others on the physiological and behavioural responses to varying levels of arterial carbon dioxide is cited, and the rationale of symptomatic treatment is discussed. Current treatment methods for hypocapnoea, although behaviourally oriented, are not closely in accord with the principles of modern behaviour therapy, and this paper suggests some directions of improvement.