Procuring organs from a non-heart-beating cadaver: commentary on a case report

Procurement of organs from non-heart-beating cadaver donors raises concerns. Standards for optimal patient care during withdrawal of life-sustaining therapy are evolving and continue to be debated and studied. Consensus on specific procedures and methods has not been attained, however, and protocols for the procurement of organs from patients following the withdrawal of life-sustaining therapies may compromise the evolving standards and harm the patient and the attendant family. In addition, there is little evidence to suggest that such protocols will significantly increase the number of organs procured. "Non-heart-beating cadaver" protocols that do not give comprehensive attention to optimal patient/family care at the time of withdrawal of life-sustaining therapy ought not to be endorsed.     

An advocacy intervention program for women with abusive partners: Six-month follow-up

Presented the 6-month follow-up findings of an experimental intervention designed to provide postshelter advocacy services to women with abusive partners. The intervention involved randomly assigning half the research participants to receive the free services of an advocate, 4 to 6 hours per week, for the first 10 weeks postshelter. One hundred forty-one battered women were interviewed about their experiences immediately upon their exit from a domestic violence shelter: 95% of the sample were interviewed 10 weeks thereafter (postintervention), and 93% were successfully tracked and interviewed 6 months later. At the 6-month follow-up, participants in both groups reported increased social support, increased quality of life, less depression, less emotional attachment to their assailants, and an increased sense of personal power. Although women in both groups reported some decrease in physical abuse over time, there were no statistically significant differences between those with and those without advocates, and abuse continued to be a problem for many women. Those who were still involved with their assailants continued to experience higher levels of abuse and had been more economically dependent upon the men prior to entering the shelter. Women who had worked with advocates continued to report being more satisfied with their overall quality of life than did the women in the control group. The authors thank the Editor and anonymous reviewers for their helpful comments. Thanks also to all present and past staff of the Community Advocacy Project, who helped in data collection and analyses. This work was supported by National Institute of Mental Health Grant 1R01 MH 44849.     

The Impact of Procedural Justice on Opinions of Public Policy: Solid Waste Management as an Example1

This study assessed the applicability of Tyler and Lind's (1992) relational model of authority to the context of local government policies on solid waste management. Tests of the hypothesized relations proposed by Tyler and Lind, accomplished through structural equation modeling, revealed that our data supported the relations between the various constructs of the model. Perceptions of both process control and relational process were found to be positively related to procedural fairness judgments, while procedural fairness judgments were weakly related to evaluations of government entities. Contrary to our expectations, a similar structural equation model test of an extension of the Tyler and Lind model showed that the model constructs were unrelated to respondents' opinions of public policies. The results also indicated that respondents living in communities with different infrastructures and political climates differed slightly in their perceptions of procedural justice and related constructs, but did not differ in their endorsement of the various solid waste management policies.     

Counseling and screening for cystic fibrosis in patients with congenital bilateral absence of the vas deferens: Patient perceptions

Congenital bilateral absence of the vas deferens (CBAVD) occurs in approximately 1.3% of infertile males and is thought to be, in most cases, a primarily genital form of cystic fibrosis (CF). Fourteen males with CBAVD considering microsurgical sperm aspiration from the epididymis (MESA) and in vitro fertilization were seen for genetic counseling and screening for CF. To retrospectively evaluate these patients' perceptions of the counseling and screening information, we conducted structured telephone interviews to assess their recall of information about CF and its impact on their health concerns and reproductive plans. We found that, as the health implications of CF are abstract and not as important to patients as the diagnosis of CBAVD itself, patients tend to view their CF status primarily in terms of their reproductive potential. Retrospective analysis afforded us an opportunity to identify the psychosocial issues of most concern to this unique patient population.     

Deficits in visual learning produced by posterior temporal lesions in cats

Eight cats with lesions in the posterior temporal (PT) cortex, seven cats with lesions in the basolateral amygdala (BLA), and eight intact controls were observed on eight tests of visual discrimination learning and of spontaneous responses to salient visual stimuli. The effects of the two lesions were somewhat dissociable. The PT lesions were accompanied by a severe deficit in pattern discrimination learning but no loss in visual tracking or orientation to the silhouette of a threatening cat. The BLA lesions produced a milder and less consistent loss in pattern discrimination but serious defects in tracking and reponse to the cat silhouette. Both operated groups performed well on the visual cliff. The deficit from PT lesions appeared independent of damage to the geniculocortical system. The parallel of symptoms from PT lesions in cats and inferotemporal lesions in monkeys is discussed.     

Tests of symmetry in three-way contingency tables

Three-dimensional contingency tables are analyzed, with one variable (e.g., sex) as a factor, and with a natural relation between the other variables (e.g. left and right eye vision). Models of special interest, like symmetry and proportional symmetry between the related variables, and homogeneity across the factor levels, are investigated. Maximum likelihood estimators of parameters and partitions of chi-square goodness-of-fit statistics are explicitly presented; the independence of certain models is noted, and an example is discussed.     

Long-term smoking intervention at the worksite: effects of quit-smoking groups and an "enriched milieu" on smoking cessation in adult white-collar employees

Maximizing the potential of worksites for smoking intervention remains elusive. We hypothesized that long-term effectiveness of group intervention would be enhanced when offered within an "enriched milieu" (full program) compared with relative isolation (group only). The data failed to support the hypothesis. Although sustained abstinence rates were higher at full-program sites (50%) than at group-only sites (44%), the difference did not achieve statistical significance. Initial (35% vs. 47%) and 12-month (18% vs. 22%) quit rates at full-program and group-only sites also failed to demonstrate the "benefit" of the "enriched milieu."     

Assessing social competencies in lower income preschool children

This study examined social competencies in 4-year-old, lower income, nonwhite preschool children in a replication of work by Shure, Spivack, and Jaeger. Age differential interpersonal cognitive problem-solving skills were investigated, i.e., ability to generate alternative solutions to interpersonal problems, consequential thinking, and school achievement as they relate to behavioral adjustment ratings by teachers and independent observers. A teacher's rating of a child as aberrant or adjusted predicted an independent observer's rating of that child in a naturalistic setting. Children who were rated as adjusted by their teachers had significantly higher scores on an achievement inventory than those children who were rated aberrant, but the study did not find the predicted relationship between problem-solving thinking and adjustment. A version of this paper was presented at the annual meeting of the American Psychological Association, New York, September 1979. The study was supported by grants from the McGregor Fund, the Eloise and Richard Webber Foundation, the David M. Whitney Fund and by the Detroit Public Schools Region 7, for which the authors express grateful appreciation. The authors also wish to thank Myrna B. Shure for her help in carrying out this replication.