STAR: A unique embedded performance assessment technique

STAR (The Strategic and Tactical Assessment Record) is a versatile research tool designed to evaluate the effects of sustained performance and other stressors on integrated, complex cognitive functioning. This completely automated task is presented in the form of a highly motivating computer game. However, unlike typical computer games, successful performance of STAR depends on an individual’s ability to rapidly and accurately assess risk/benefit ratios in a variety of situations, and on the skilled use of an array of multipurpose control systems. STAR is unique in that approximately 80 performance measures are unobtrusively embedded in the operations required to “play the game”; no obvious performance assessment interferes with task presentation. STAR provides multiple measures of psychomotor function, attention, memory, information processing, decision making, risk-taking behavior, subjective state, errors, and error paths. In this report, we describe STAR, and summarize two preliminary experiments designed to separately evaluate the effects of task difficulty and task stress level on complex performance.     

Psychotherapie bei lebensbedrohlich Erkrankten

In den letzten 20 Jahren ist die begleitende psychotherapeutische Behandlung bei körperlich Schwerkranken fester Bestandteil der Tätigkeit von psychosomatischen Konsiliar- und Liaisondiensten im Krankenhaus geworden. Eine Konzeptualisierung dieser Tätigkeit auf psychodynamischer Basis wird beschrieben. Ziele der psychotherapeutischen Interventionen sind die Stabilisierung der Abwehr des Patienten und die Rückgewinnung eines strukturierten Umgangs mit der Krankheit, mit den Behandlern und den nahen Bezugspersonen. Therapiebausteine sind eine narrative Gesprächsstruktur, ein psychodynamisches Verständnis der aktuellen Krankheitssituation auf dem Hintergrund der Lebensgeschichte, aktives Zuhören, Fokusformulierung und systemische Sichtweise. Wichtige Wirkfaktoren sind eine empathische Beziehung, Verbalisierung von belastenden, negativen Gefühlen, Fokussieren auf aktuelle Probleme und Ressourcenorientierung. Probleme entstehen durch negative Gegenübertragung des Psychotherapeuten und ausgeprägte Verleugnungsvorgänge auf Patientenseite. Die Umsetzung erfordert vom Psychotherapeuten kontinuierliche Präsenz und regelmäßige Rücksprachen und Konsultationen mit dem behandelnden Team.     

Extreme Versatility Versus Paucity of Play Interest

Abstract

Reorganisation of the public school system. By Frank Forest Bunker. Bureau of Education, Bulletin, 1916, No. 8. 186 pages. Reviewed By A. A. Douglass

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The Development of Strategic Processing of Ambiguous Words: Riddles Versus Neutral Context

Children in Grades 4 and 6 read isolated target words following the auditory presentation of an ambiguous word (e.g., deck). The ambiguous word occurred as the last word in either a neutral sentence (e.g., “There is the deck”) or as the last word in a riddle (“Why couldn't anybody play poker on the ark? Because Noah sat on the deck). Related target words were consistent with either the dominant meaning (e.g., porch) or the subordinate meaning (cards) of the ambiguous word. In the neutral context, Grade 4 children showed equivalent facilitation for dominant and subordinate targets relative to unrelated target words; Grade 6 children showed facilitation only for the dominant targets. In the riddle context, both groups of children showed equivalent facilitation for the two types of related targets. The neutral context results supported the hypothesis that the two bases of context effects—automatic lexical access and selective access—develop at different rates (Simpson &; Foster, 1986). The results obtained from the riddles suggest that the selective process is strategic (Ceci, 1989).     

Correcting distorted perception of sleep in insomnia: a novel behavioural experiment?

Patients with primary insomnia overestimate their sleep onset latency (SOL) and underestimate their total sleep time (TST). The present study aimed to test the utility of a novel behavioural experiment designed to correct distorted perception of sleep among patients diagnosed with primary insomnia. Individuals with primary insomnia were asked to wear an actigraph and keep a sleep diary for three nights. On the following day, half were shown the discrepancy between the data recorded on the actigraph and their sleep diary (Shown-Discrepancy Group), the other half were not shown the discrepancy (No-Demonstration Group). Participants were then asked to wear the actigraph and keep a sleep diary for three further nights. Following the behavioural experiment, the Shown-Discrepancy Group estimated their SOL more accurately and reported less anxiety and preoccupation about sleep compared to the No-Demonstration Group. The theoretical and clinical implications of these findings are discussed.     

Body asymmetry affects conjugate lateral eye movement

A. H. Baker (1989) and A. H. Baker and A. I. Ledner (1990) reported that asymmetrical visual stimulation affects conjugate lateral eye movement (CLEM). In the present article, the authors explored whether asymmetrical body position similarly affects CLEM. The authors assessed CLEMs twice in a counterbalanced design. In the control (symmetric) condition, each participant sat in a completely symmetrical position facing a wall devoid of any asymmetrical features. In the experimental (asymmetrical) condition, half the participants rotated their heads 68 degrees clockwise relative to their bodies to face the experimenter, and the other half rotated their heads 68 degrees counterclockwise, also to face the experimenter. CLEM was predominantly toward the body's position in the asymmetrical condition rather than toward the body's position in the symmetrical condition.     

"Broken covenant": healthcare aides' "experience of the ethical" in caring for dying seniors in a personal care home

Canada's population is aging, and seniors constitute the fastest growing demographic in the nation. The chronic health conditions, limited social support, functional decline, and cognitive impairment experienced by seniors may necessitate admission to a personal care home (PCH) setting up until the time of their death. The ethical problems that arise in the care of dying patients are numerous and complicated. The care of dying seniors in PCHs, however, is largely provided by frontline workers such as healthcare aides (HCAs), who usually have little training in palliative care or ethics. Research examining the identification and resolution of ethical problems in care of the dying has been conducted from the perspectives of nurses and physicians in various clinical settings, but the voice of HCAs in PCHs is virtually absent from clinical ethics. Given that the inability to satisfactorily resolve ethical issues in clinical practice is associated with feelings of guilt, powerlessness, avoiding contact with patients, failing to provide good physical care, and increased staff turnover, an empirical examination of HCAs' experiences of ethically challenging situations is warranted. We conducted a phenomenological study to access the lived experience of HCAs (N = 12) working in proprietary and nonproprietary care homes as they encountered situations they deemed ethically challenging in providing end-of-life care to dying seniors. The findings reported here explicate: (1) the types of situations that are ethically problematic for HCAs; (2) the meanings they assign to these situations, and (3) the impact such situations have on the provision of end-of-life care.