The role of identity in how whole‐blood donors reflect on and construct their future as a plasma donor

In the context of decreased demand for whole blood and increased demand for plasma‐derived products, donors in Australia are increasingly being asked to convert from whole‐blood to plasmapheresis donations. Plasmapheresis is a different type of donation to whole blood as the process takes longer and can be engaged in more frequently. What is unknown is whether whole‐blood donors view donating plasma as consistent with their donor identity and how they respond to the possibility of donating more frequently. To explore this, we undertook semistructured telephone interviews with 26 whole‐blood donors who had recently made their first plasma donation. Findings indicated that whereas donating plasma was viewed as a bigger ask than donating whole blood, the former was viewed as consistent with their identity as a donor because both behaviours were seen to benefit others and self and were located within the same institutional context. Donating plasma was an opportunity for donors to enhance their self‐concept as an altruistic giver. When contemplating their future donation behaviour, donors considered how their donor identity would fit alongside other salient roles. These findings have implications for how institutions can position their request of existing donors to give a different gift.     

Issues in the identification and long-term management of Munchausen by Proxy Syndrome within a clinical infant service

Munchausen by Proxy Syndrome is a version of Munchausen's Syndrome whereby a parent, usually the mother, simulates or fabricates disease in one or more of her children in order to seek medical attention. Because this disorder is usually identified in pediatric settings, current literature focuses on identification of the syndrome, with little discussion of treatment issues or management strategies other than confrontation of the parent and removal of the child from the home. With the increased availability of infant mental health services, infant clinicians are likely to be called on to evaluate and treat cases of this disorder. This paper reviews the Munchausen by Proxy literature for infant clinicians and describes the identification and long-term management of one Munchausen by Proxy case within the context of an infant home-visiting service. Pertinent issues that emerged included the difficulties inherent in documenting the mother's pathological behavior, the clinical tension between preventing flight from treatment but limiting harmful behavior, the need for a long-term collaborative relationship with a designated pediatrician, and the importance of further education of protective service workers about this syndrome.     

Serotonin metabolism and serotonergic receptors in Norway rats selected for low aggressiveness to man

Selection of Norway rats (24–27 generations) for low aggressiveness to man resulting in the loss of aggressive responding to handling markedly influences the brain serotonergic system. In “domesticated” Norway rats levels of serotonin in the midbrain and hypothalamus and 5-hydroxyindole acetic acid in the hypothalamus were higher than in non-selected aggressive rats. The activity of the key enzyme in serotonin biosynthesis, tryptophan hydroxylase, in midbrain of rats with genetically determined lack of aggressiveness to man was higher than in aggressive animals, although there was no difference in tryptophan hydroxylase activity in the hypothalamus. B_max and K_D of [³H]spiperone-specific binding in frontal cortex membranes were increased in tame rats. No significant differences in B_max and K_D were found between “domesticated” and aggressive rats in [³H]serotonin binding in the frontal cortex.     

Selection for reduced aggressiveness towards man and dopaminergic activity in Norway rats

The brain dopaminergic system is involved in the process of long-term selection for reduced aggressive reaction towards man in Norway rats. The dopamine levels in the striatum as well as the nucleus accumbens with the tuberculum olfactorium were significantly lower in domesticated rats than in their wild counterparts. A substantial decrease was found in homovanillic acid level in the n. accumbens and tuberculum olfactorium. Specific binding of [³H]spiperone which labels D-2 dopamine receptors was higher in the mesolimbic structure of tame rats, whereas binding of [³H]SCH 23390 (D-1 receptors) was unchanged in this area. No substantial differences were detected in D-1 and D-2 binding in striatum. Apomorphine (0.3 mg/kg) elicited less locomotion in tame animals, reflecting a decrease of sensitivity of postsynaptic dopamine receptors. Tame rats showed fewer aggressive contacts in a foot-shock test than wild rats and the D-2 receptor antagonist sulpiride (25 mg/kg) significantly decreased the foot-shock aggression only in wild rats. Therefore, domestication, which diminishes defensive behavior and emotional reactivity of animals, is associated with decreases of dopamine level in the striatum, changed metabolism of dopamine in mesolimbic system, and an alteration in density and senstivity of D-2 receptors.     

Orientation-specificity in kinesthetic spatial learning: The role of multiple orientations

In the current study we tested whether multiple orientations in kinesthetic learning affected how flexibly spatial information is stored and later used in making location judgments. Three groups learned simple routes by walking them while blindfolded, with (1) multiple orientations achieved through normal walking, (2) multiple orientations achieved through backward walking, or (3) a single orientation achieved through walking without turning (which required forward, backward, and sideways walking). When subjects had experienced multiple orientations while learning the routes, later directional judgments were equally accurate (and equally rapid) regardless of whether the judgments were aligned or were contra-aligned with the orientation of the routes as originally learned. In contrast, when routes were learned in a single orientation (without turning), subsequent judgments on contra-aligned trials were both less accurate and slower than judgments on aligned trials. Thus, multiple orientations are important to establish orientation-free, flexible use of spatial information in a kinesthetic learning environment. This contrasts with the pattern of results typically found in visual spatial learning and suggests that the factors that affect orientation specificity of spatial use may differ across spatial modality.     

Cognitive development and locus of control as predictors of preschoolers' understanding of safety and prevention

Preschoolers' cognitive level and locus of control orientation and their parents' locus of control orientation were considered as possible predictors of children's abilities to differentiate between safe and unsafe situations (safety score) and specify preventive measures (prevention score). Individual interviews were conducted with 3- to 6-year-old children enrolled at a daycare center, and their parents completed the Rotter Internal-External Locus of Control and the Accident Locus of Control (ALOC) scales. As hypothesized, children's level of causal reasoning was positively correlated with their safety and prevention scores. A curvilinear relationship was evident relationship existed with prevention score. Fathers' ALOC score was the only parent measure that predicted children's safety score, while none of the parent measures were predictive of children's prevention score. The findings were discussed in terms of safety education programs and directions for future research.     

Residual reading capability in a patient with alexia without agraphia

A case of pure alexia due to an ischemic lesion of the occipital temporal region is described. Written words could be matched but not read. Immediate memory span for graphemes was defective. The reading defect probably depends on the inability to modify the written word “globally”; the phonological process was intact, but the memory disturbance impeded reading. The dissociation is explained by the preservation of word forms, which are linked to the semantic stage. Nonwritten stimuli trigger a “meaning” which evokes the word form and so the written word is recognized even though it cannot be read.     

Women's Understanding of Their Risk of Developing Breast/Ovarian Cancer Before and After Genetic Counseling

Many studies have reported that individuals frequently over- or underestimate their risk of developing cancer both before and after they attend genetic counseling for breast and/or ovarian cancer. Using a combination of interviews and written questionnaires, we investigated counselees' understanding of their risk of developing cancer before and after genetic counseling. We demonstrate that although 76% of the sample thought that their risk was elevated relative to women in general, only a small proportion (17%) were willing or able to provide a numerical estimate of their risk of developing cancer before they attended the clinic. Following the consultation, 43% indicated that their risk of developing cancer was lower than they had anticipated. Twenty-two percent described their risk in absolute rather than relative terms, i.e., that they would definitely (not) develop cancer in the future. The implications of these findings for further research are discussed.     

Family Communication and Genetic Counseling: The Case of Hereditary Breast and Ovarian Cancer

In familial breast/ovarian cancer, the information that the proband is able to supply about other family members is of critical importance for genetic counseling. This frequently requires family communication. Forty-six women attending a cancer genetics clinic were interviewed as part of a longitudinal study. Nearly all reported affected maternal, rather than paternal relatives, which may indicate lack of awareness by women with paternal histories. There was also much more communication among female relatives. Mothers, where they were still alive, were key figures in supplying family information. Although the majority of the sample contacted at least one relative regarding counseling, most named a relative with whom they did not feel able to communicate on this subject. Probands balanced the perceived obligation of passing on information with that of not causing alarm. Communication, both obtaining and giving information, was impeded by adoption, divorce and remarriage, family rifts, and large age gaps between siblings.     

Substance use as an employee response to the work environment

A conceptual framework for the examination of alcohol and drug use as employee responses to work environments is proposed. Three sets of substance use antecedents are discussed. These are distancing forces, attractions, and constraints. Examples of these antecedents within the organizational setting are provided, and the dynamic interrelationships among them explored. Conditions for the use of different types of substances are also identified.