Case vignette: premature surrender

Three commentaries are offered on the following case: George, age 57, is a previously healthy man who recently underwent surgery for removal of a low-grade malignant thymoma. At the time of admission to the hospital, George stressed to the staff that he had long ago signed a "living will," which he renewed immediately after he learned of his cancer diagnosis. At the time of surgery, the tumor was found to extend into his mediastinum; although it was removable, this required revision of part of the sternum and grafting of the vessels feeding the heart chambers. Because of the resultant tissue damage and neuronal hyperactivity, George experienced postoperative episodes of cardiac arrhythmia and bronchospasm. Unanimous medical opinion was that this situation was a temporary problem that would resolve itself as the tissues healed. Until that time, however, it will be difficult to wean him from ventilatory support. When his stay in the intensive care unit became prolonged, George and his family began to insist that his status be changed to "do not resuscitate" and reminded the staff about his longstanding living will. All of this is happening despite the fact that the patient and family seemingly comprehend that although the short-term interventions are invasive, there is a high probability of a successful outcome. George's cancer prognosis is excellent, and, although he may well have an episode of life-threatening arrhythmia, he is likely to respond to resuscitation interventions. Once the immediate postoperative period is over, his potential for a long and productive life with full capacities is excellent. Consider the following questions: (a) Should George's expressed wishes be respected, or should the staff take additional steps to help him survive the postoperative period, even if that means violating his stated wishes? and (b) What steps might the staff follow in sorting through this problem?     

Theory change in immunology part II: The clonal selection theory

This two-part article examines the competition between the clonal selection theory and the instructive theory of the immune response from 1957–1967. In Part I the concept of a temporally extended theory is introduced, which requires attention to the hitherto largely ignored issue of theory individuation. Factors which influence the acceptability of such an extended theory at different temporal points are also embedded in a Bayesian framework, which is shown to provide a rational account of belief change in science. In Part II these factors, as elaborated in the Bayesian framework, are applied to the case of the success of the clonal selection theory and the failure of the instructive theory.     

The accuracy of maternal self-reports: Agreement between reports on a computer simulation compared with observed behaviour in the supermarket

The validity of maternal self-reports about their parenting behaviour is evaluated with two studies. In both studies, the mothers were observed shopping in the supermarket with their 2-year-old children. One week later they responded to multiple choice questions on a computer that simulated the experience of shopping with their children. The exact agreement between the two types of data was then assessed. The results from the first study involving 28 mothers revealed some agreement, although it was generally low. In an effort to increase the level of agreement, the computer simulation was revised to allow multiple responses and to clarify some of the simulation vigenettes. A replication study resulted in a considerably higher level of agreement for 22 mothers. Implications of this method for researchers and practitioners are discussed.     

Myth Information and Bizarre Beliefs of Male Juvenile Sex Offenders

The author describes mythical beliefs, thinking errors, and faulty attitudes collected from a group of male juvenile sex offenders. Therapists need this information to develop effective treatment strategies for replacing distortions and misperceptions with correct and moral information as a foundation for change.     

A simple and sensitive method for monitoring running-wheel movement

A running-wheel movement-detection method is described for use with a modified 1350 Commodore mouse and a Commodore 64, is described. The movement-detection method allows for the detection of partial revolutions and direction of movement, but requires no interface equipment. The modified running wheel is discussed as a new technique that may be useful for bridging empirical and theoretical differences between free-operant and discrete-trial runway procedures.     

The effect of unilateral stellectomy on the regulation of heart rate during behavioral stress

Changes in heart rate were examined during classical aversive conditioning before and after either left (n=10) or right stellectomy (n=8). Heart rate (HR) significantly (p<0.01) increased in response to the conditional stimulus with a further increase noted during the unconditional stimulus. After right stellectomy (RSGx) the aversive stress elicited a significantly (p<0.01) smaller increase in heart rate (peak HR change: control 66.8 +/- 6.0; RSGx 36.1 +/- 6.8 beats/min). In contrast left stellectomy did not significantly alter the heart rate conditional response. Cardioselective beta-adrenergic receptor blockade, metoprolol HCl (BB, 1.0 mg/kg, n=8), significantly (p<0.01) reduced the heart-rate conditional response (peak HR change: control 66.8 +/- 6; BB 25.1 +/- 3.8 beats/min) to the same extent as noted during RSGx. These data suggest that the heart-rate increases elicited by aversive stress are mediated in part by sympathetic nerves that originate or pass through the right stellate ganglion. The residual HR increase noted after RSGx or BB probably results from the withdrawal of cardiac parasympathetic activity.     

Orientation-contingent color aftereffects mediated by subjective transparent structures

We examined whether the orientation-contingent color aftereffect (the McCollough effect) could be mediated by subjective horizontal and vertical structure induced by the perception of transparency. In our experiments, red vertical bars and green horizontal bars were alternated as an adapting stimulus. After adaptation, subjects (n=6) were asked to adjust the green and red saturation of a test pattern until they obtained a neutral gray. Horizontal and vertical stripes were combined in the test pattern in three different ways: (1) overlapping with a luminance combination that gave rise to a perception of transparent overlays of horizontal and vertical stripes (valid transparency condition), (2) overlapping with luminance combinations that did not induce a perception of transparency (invalid transparency condition) and that appeased more as a patchwork of checks, and (3) presented in adjacent, nonoverlapping areas. Our results showed that the McCollough effect was significantly greater in the valid transparency condition than in the invalid transparency conditions. The effect in the valid transparency condition was nevertheless less strong than was the effect seen with the standard test stimulus made up of nonoverlapping vertical and horizontal stripes, Our results suggest that the McCollough effect can be mediated by the subjective spatial organization (inner representation of vertical and horizontal stripes) that accompanies the perception of transparency in our stimulus.     

Alternating least squares algorithms for simultaneous components analysis with equal component weight matrices in two or more populations

Millsap and Meredith (1988) have developed a generalization of principal components analysis for the simultaneous analysis of a number of variables observed in several populations or on several occasions. The algorithm they provide has some disadvantages. The present paper offers two alternating least squares algorithms for their method, suitable for small and large data sets, respectively. Lower and upper bounds are given for the loss function to be minimized in the Millsap and Meredith method. These can serve to indicate whether or not a global optimum for the simultaneous components analysis problem has been attained.Financial support by the Netherlands organization for scientific research (NWO) is gratefully acknowledged.     

Minimizing the number of observations: A generalization of the spearman-brown formula

A new method for determining the minimum number of observations per subject needed to achieve a specific generalizability coefficient is presented. This method, which consists of a branch-and-bound algorithm, allows for the employment of constraints specified by the investigator.     

ACTH 4-9 analog can retard spatial alternation learning in brain damaged and normal rats

Thirty adult male hooded rats (Long-Evans strain) were assigned randomly to one of three lesion groups (n = 10) and prepared with medial frontal, posterior parietal, or sham neocortical injuries. Following a recovery interval of 10-12 days, access to water was limited to 30 min per day and the rats were shaped to traverse a T-maze for a reward of sweetened water. After a pretraining criterion was attained, osmotic minipumps (Alzet 2002) were installed subcutaneously. The minipumps delivered chronically for the next 14 to 15 days either 0 or 1.2 micrograms of ACTH 4-9 dissolved in bacteriostatic saline per day while the rats were trained on a reinforced spatial alternation task. Analysis of the number of errors made to a criterion of at least 80% correct alternations in two consecutive training sessions, or a ceiling of 62 errors (attained by two rats with parietal lesions), revealed that learning was impaired in the rats with parietal injuries. Contrary to our hypothesis, animals receiving ACTH 4-9 committed more errors than their counterparts receiving only saline.