Circadian factors during sustained performance: Background and methodology

Cornell University Medical College, Westchester Division, The New York Hospital, White Plains, New York It is well established that there is a complex timekeeping mechanism in the human brain. This mechanism is associated with a variety of physiological and psychological rhythms having a period of about a day, and thus referred to as circadian rhythms. The circadian system has recently been modeled in terms of two underlying oscillators, one much more resistant to changes in routine than the other. These oscillators are considered to be endogenous, that is, internal to the organism, and not reliant for their existence upon changes in the person’s environment or general behavior. They thus continue to run even when the sleep/wake cycle is suspended, as in sustained operations. Thus, by their very nature, sustained operations require the individual to override the inputs that are coming from his or her circadian system (especially the indication that sleep is required). The aim of this paper is to provide a background to the area of circadian rhythms research, including a section on the methodology, so that the impact of the circadian system on sustained operations can be better understood.     

Treatment of urinary urgency and excessive frequency: a case study

A 39-year-old male presenting with a 5 year history of excessive urinary frequency and urgency was treated first with scheduling of urination, use of external urinary catheter and progressive muscular relaxation and then with a urinary retention training procedure. After the first set of procedures, urinary frequency decreased, whereas urgency increased slightly. After completion of retention training, both symptoms were alleviated. Overall, urinary frequency decreased from a baseline average of 14 urinations daily to a post-treatment average of 6.5 urinations per day. Urinary urgency decreased from a baseline average of 35 urges per day to a post-treatment average of 9.3 urges per day. Gains were maintained at 3 and 5 month follow-up.     

Confidentiality: a survey in a research hospital

Despite the many justifications for protecting patient confidentiality, we recognize that confidentiality cannot be absolute. Our world of automated information and easy access and storage poses many threats to confidentiality. This paper has described a survey conducted at the NIH Clinical Center to assess the knowledge, attitudes, and behaviors of clinical physicians and nurses about confidentiality of patient information. The survey findings demonstrate the need for reminders and increased awareness about confidentiality in our setting. Most of the survey respondents had a good knowledge of what was expected of them, and they believed that confidentiality was important and maintaining it was their responsibility. Of interest was that in several simulated clinical situations, there was a discrepancy between what respondents indicated they should do and what they thought they would do. The biggest discrepancies appeared in situations that involved overhearing a patient conversation on the elevator, approaching an unfamiliar person who is reading a medical record in the nurses' station, and answering a patient's inquiry about the status of another patient. The findings support the speculation that this difference may be attributed to discomfort or decreased awareness, and not necessarily to lack of knowledge. Results indicate that policies and administrative expectations should be frequently communicated and enforced, and that educational programs that address issues of confidentiality should be provided. The results of this survey have been influential in guiding educational strategies and administrative activities at the clinical center. The clinical center initiated a confidentiality awareness campaign, displaying a new poster every three months in strategic locations and distributing other tangible reminders (such as pens, magnets, and buttons) containing the same confidentiality message.(ABSTRACT TRUNCATED AT 250 WORDS)     

THE GENERALIZATION EFFECTS OF PARENT TRAINING ACROSS STIMULUS SETTINGS

Five parents of nonverbal children were trained in two home settings to modify antecedents and consequences to their children's vocalizations. Generalization effects of the parent training on both the parent's and children's behaviors under different stimulus conditions were investigated using multiple-baseline designs. Increases in parent prompting and reinforcing their children's vocalizations generalized only minimally to a new setting in the home where parent training had not occurred. Child increases in vocalizations produced by the parents in the training settings did generalize to this new setting in the home. There was minimal generalization of child vocalizations to a free-play setting at school. In a formal speech session conducted by a behavior specialist at school, only one child showed definite increases in acquisition rate as a function of the parents starting to train the sound at home.     

Creating Creativity: A Behavior Analytic Approach

The Psychological Record - Creativity and innovation have brought about phenomenal changes throughout human history. Art, science, medicine, industry, and technology have all grown through creative...     

An Intersectional Approach to the Glass Ceiling: Gender,Race and Share of Middle and Senior Management in U.S. Workplaces

A robust body of research examines factors affecting the likelihood that women experience increasing barriers to promotion in workplaces. However, limited research examines how racialized and gendered processes may intersect and work differently for racially and gender marginalized workers. Specifically, the processes relating to a worker’s ability to reach middle-level management positions (e.g., those managers who oversee a small group of employees) and senior-level management positions (e.g., CEOs and other executive positions) may vary based on workers’ race and gender. Using 2015 EEO-1 data collected by the U.S. Equal Opportunity Employment Commission (EEOC), we examine how the characteristics of a workplace affect Black men, Black women, White men, and White women’s share of middle- and senior-level management. We find Black women and Black men are strikingly under-represented in both middle and senior management in private-sector workplaces. Our results demonstrate that access to middle- and senior-management varies by the characteristics of the workplace and workers’ race and gender. Overall, our findings point to an important implication: Greater oversight of workplaces, including by the EEOC, is associated with marginalized race/gender groups having higher shares of management.