The Patient Self-Determination Act and Advance Directives: Snapshots of Activities in a Tertiary Health Care Center

This study describes the results of a retrospective review of patients' charts who had an advanced directive (AD) and who were hospitalized in a tertiary, acute care teaching hospital. The purpose of the review was to understand from clinical, sociological, ethical and legal perspectives the nature and utility of ADs. Findings and implications of the review are discussed in terms of: patient demographics; diagnoses; quality of ADs; influence of ADs on clinical decisions; and legal aspects of ADs.     

Me,us and them: Political identification and the third-person effect in the 1993 Australian federal election

Three days prior to the 1993 Australian federal election 54 Australian university students who identified with one of the two major political parties were surveyed regarding their perceptions of media campaign impact on self and others. Results provided evidence of a third-person effect (Davison, 1983) wherein respondents judged others us more influenced by the election campaign than themselves. Consistent with predictions derived from social identity theory and self-categorization theory (e.g. Turner, Hogg, Oakes, Reicher and Wetherell, 1987), political ingroup members were also judged as less injuenced by campaign content than political outgroup members. Respondents who identified strongly with their preferred party judged self and ingroup members as less influenced by campaign content than did other respondents, and showed more evidence of positive intergroup differentiation. At the same time, however, these respondents exaggerated self–ingroup differences, challenging the theoretical assumption that intergroup diferentiation is associated with ingroup assimilation. Judgements of media impact on self and other also depended on the direction of the campaign message. Respondents believed ‘voters in general’ were persuaded in line with the intent of campaign content, while outgroup members were seen to be persuaded by material favouring their own side but to be uninfluenced by counter-attitudinal content. Election propaganda, irrespective of direction, was seen to amplify existing party preferences in self and ingroup members. Hence the relative invulnerability of self to media impact was pronounced when respondents judged the impact of pro-outgroup messages. Results suggest that perceptions of self–other differences in media vulnerability are influenced by the subjectively salient social relationship between self and other, and are governed by motivational needs, such as self-esteem, social-identity, and differentiation from others (cf. Brewer, 1991; Hogs and Abrams, 1993).     

Parents' gender-based attitudes toward marital roles and child rearing: Development and validation of new measures

Factor analysis of 18 Likert-type items dealing with gender stereotypes about family roles was conducted and yielded two measures: one focused on marital roles and one focussed on child rearing. Respondents were parents of children in the third and fourth grades of a large industrialized city in the Midwest. The sample included 364 families equally divided between middle and lower class with 23% African American and 77% European American. For both scales, more stereotyped scores were obtained by parents who were lower in social status, less educated, full-time homemakers, African Americans, and fathers. Parents' scores related to a separate measure of children's stereotypes and the marital-role attitudes related to actual roles reported by family members. Daughters whose parents obtained less stereotyped scores had a more internal locus of control, showed a trend toward more independent coping skills, and—in the middle class—obtained higher scores on achievement tests.This research was supported by Grant No. 91-1437-91 from the William T. Grant Foundation.     

Evaluating children's mental health service systems: An analysis of critical behaviors and events

A lack of studies which evaluate system change by tracking client outcomes is noted in the children's mental health area. This deficit may be a result of the inability of researchers to define outcomes and to draw conclusions about which measures reflect the efficacy of services and service delivery systems. This paper reviews five social validation surveys which examined children's mental health outcome measures. Based on the results of the five surveys, a model of critical behaviors and events is presented. This model will assist evaluators and researchers in understanding which critical events and behaviors should be measured to assess the impact of community-based mental health services for children.     

A selective and critical review of neuropsychological deficits and the frontal lobes

Presumptions about the functions of the frontal lobes, and the sensitivity and specificity of certain tests to measure frontal lobe functions, are having a substantial influence on both clinical and research conclusions. In this paper the authors examine the details of the studies that have contributed to these presumptions, and find that the evidence to support these conclusions is weak. A detailed evaluation of the evidence relating to the Wisconsin Card Sorting Test and the Thurstone Word Fluency Test is also presented. Finally, the development of the belief that frontal lobe functions can be specifically measured is reviewed. The authors of this paper conclude that the bewildering array of deficits attributed to frontal lesions still seems to prevail.     

A study of neuropsychological impairment among school-indentified learning-disabled students

This investigation examined the proportion of school-identified learning-disabled (LD) students who scored in the impaired range on the Halstead Reitan Neuropsychological Battery for Children (HNBC) over a 20-year period. A difference was noted in findings for periods before and after the passage of federal legislation (Public Law 94-142); specifically, the proportion of LD students who scored in the impaired range on neuropsychological tests was significantly higher prior to than after this law. A similar pattern of impaired performance across the different tests was noted before and after the legislation. The implications of these results for theorists and practitioners are discussed.     

Compound word effects differ in reading,on-line naming,and delayed naming tasks

Bimorphemic compound words (e.g.,blueberry), bimorphemic suffixed words (e.g.,ceaseless), and monomorphemic controls (e.g.,arthritis) were read in neutral sentence contexts in Experiment 1. The main result revealed longer first fixation durations on compound words than on control and suffixed words. Different effects emerged when naming tasks were used. An on-line naming task revealed substantially shorter naming latencies for compound words than for control and suffixed words. Naming latencies for compound and control words were equivalent in a delayed naming task. These results indicate that on-line naming latencies and word-viewing durations may yield diverging results. They also suggest that activation of constituent words of compound words occurs independently from the specification of conventional word meanings.     

Concordance Between Mothers' and Children's Reports of Somatic and Emotional Symptoms in Patients with Recurrent Abdominal Pain or Emotional Disorders

Mother–child concordance regarding children's somatic and emotional symptoms was assessed in children with recurrent abdominal pain (n = 88), emotional disorders (n = 51), and well children (n = 56). Children between 6 and 18 years of age and their mothers completed questionnaires assessing the children's somatic symptoms, functional disability, and depression. Mothers of children with recurrent abdominal pain reported more child somatic and depressive symptoms than did their children, and mothers of children with emotional disorders reported more child depressive symptoms than did their children. Higher levels of maternal distress were associated with greater mother-child discordance in the direction of mothers reporting more child symptoms than did their children. No significant child age or sex differences were found in concordance patterns.