The Heart of the Matter: An Essay about the Effects of Managed Care on Family Therapy with Children*

This essay is based on a pilot study that examined the effects of managed care on the treatment of children and families, with special attention to community mental health. We embarked on the pilot study to test the accuracy and generalizability of our impression that family therapy and other systemic practices have been marginalized in ordinary clinics and agencies, and to understand the reasons why. We interviewed managed care providers, researchers, family therapy trainers, and clinicians in the Northeast. Our findings led to seven themes that support our impression that, even though there is a consensus about the need for coordinated family-based services, there is a disconnection between state policies, contractual requirements and what is actually occurring at the implementation level. This study suggests that our knowledge of human systems may be in danger of being disqualified and lost, with damaging consequences for the care of children. Yet, as systemic thinkers and practitioners, it is our belief that ethical and effective treatment need not be at odds with care that is cost-efficient. The direction of our future research will be to study whether the involvement of all stakeholders at all levels of planning and training leads to systemic family-based practices that consistently save costs and provide high-quality care.     

Age-related changes in working and reference memory performance and locomotor activity in the Wistar rat

Wistar rats of three age groups were tested in an automated tunnel-maze system of variable geometry to investigate whether changes in spontaneous locomotor activity and in learning and memory develop differentially or in a correlated fashion as a function of age. Senescent (30 months) as well as mature-adult (17 months) rats showed an age-correlated decline of locomotor activity as compared to the mature-young (5 months) group. Both working-memory (measured as within-trial arm discrimination performance) and reference-memory (measured as avoidance of "blind alley" visits) were severely affected in the senescent group, whereas the middle-aged animals suffered only from a working-memory deficit. The findings provide evidence that locomotor deficits do not necessarily interfere in the assessment of age-related changes in cognitive performance. Furthermore the results support the hypothesis that working and reference memory have different underlying physiological correlates and that these neuronal systems are differentially affected by the aging process.     

Listeriosis of the central nervous system in children beyond the neonatal period

Observations on three children with neurolisteriosis (one case of meningitis, two cases of meningoencephalitis, each Serovar 4 b), show that even after the neonatal period, listeriosis must not be ignored in the process of diagnosis and therapy. It is the bacteriological examination of the cerebrospinal fluid, together with the blood culture, and not clinical symptoms and serology that guarantee a timely diagnosis and therapy (ampicillin and gentamicin).     

Visual Elaboration Scale as a measure of imagery

We studied the correlation of one measure of imagery ability, the Visual Elaboration Scale, with two others, absorption of image and effort required to form a mental image. Significant correlations were obtained between the Visual Elaboration Scale and the other scales, with the exception of Absorption for women.     

Sleep in the dove Zenaida asiatica

Electrographic and behavioral observations were made in five adult birds of the genus Zenaida asiatica. Five different vigilance states were quantitated: (1) Active waking (Aw) was characterized by constant behavioral activity; the nuchal electromyogram was tonically active with bursts associated to movements. The electroencephalographic pattern was low voltage and high frequency. (2) Quiet waking (Qw) was characterized by diminished behavioral activity and the EEG pattern was similar to that of Aw. (3) Drowsiness (D) was characterized by behavioral calm. Frequency of cerebral activity diminished progressively, but there were short periods of desynchronization corresponding to brief awakenings. (4) Slow wave sleep (SWS); during this period there was behavioral rest and EEG pattern of continuous slow waves and the nuchal EMG was tonically reduced. Spindles of sleep were not observed. (5) Paradoxical sleep (SP), behaviorally characterized by phasic manifestations consisting of noddings originated by rapid falling down of head and bursts of rapid eye movements. EEG activity was like that of waking state. EMG activity was maintained at the same level as during SWS but sometimes it decreased lightly. Total atonie was not observed. Sleep percentages were higher when recordings were done during the nocturnal period.     

A developmental-genetic analysis of aggressive behavior in mice (Mus musculus): III. Behavioral mediation by heightened reactivity or immobility?

This research was designed to investigate development and behavioral mediation in lines of ICR mice that have been selectively bred for aggressive behavior. General behavioral reactivity and behavioral immobility have been implicated as potential mediators by prior analyses of preattack interactions. To evaluate the separate roles of these dispositions, the emergence of attacks in genetically selected lines was tracked for 11 years by three levels of analysis: over successive generations, over development, and over dyadic interactions. Convergent outcomes were observed in all three levels with respect to two findings: (a) Robust line differences were obtained in attack behaviors, and (b) strong associations were found between line differences in attacks and line differences in behavioral immobility. Conversely, all three levels of analysis indicated a weak and inconsistent association between line differences in attacks and measures of social and nonsocial reactivity.