Medical expertise asa function of task difficulty

This paper is concerned with factors that disrupt the pattern of forward reasoning characteristic of experts with accurate performance. Two experiments are described. In the first, the performances of cardiologists, psychiatrists, and surgeons in diagnostic explanation of a clinical problem in cardiology were examined. In the second, the performances of cardiologists and endocrinologists in diagnostic explanation of clinical problems within and outside their domains of expertise were examined. The performances of researchers and practicing physicians are also compared. The results of Experiment 1 replicated earlier results regarding the relationship between forward reasoning and accurate diagnosis. There were no differences in recall as a function of expertise. Experts did not show any bias toward using specific knowledge from their own areas of expertise. The results of Experiment 2 showed that the breakdown of forward reasoning was related to the structure of the task. In particular, nonsalient cues induced some backward reasoning even in subjects with accurate diagnoses. Some differences were also found between the types of explanation used by researchers and practitioners. The practitioners referred more to clinical components in their explanations, whereas the researchers focused more on the biomedical components.     

Changes in information as a function of a culturally appropriate smoking cessation community intervention for Hispanics

Tested a 7-month, media-based, community intervention among Hispanics in San Francisco designed to change levels of information on the damaging effects of cigarette smoking and on the availability of culturally appropriate cessation services. Three community-wide surveys of Hispanics were conducted with independent random samples, two as baselines (n = 1,660 and 2,053) and one postintervention (n = 1,965). Results showed that changes in the level of awareness of cessation services had taken place after implementation of the intervention. Furthermore, those changes took place primarily among the less acculturated Spanish-speaking Hispanics who were the target of the intervention. The changes in information reported here demonstrate that a culturally appropriate information dissemination campaign that utilizes multiple channels can produce changes in a community's level of information even when the campaign is implemented for a relatively short period.     

Effects of Level of Processing on Implicit and Explicit Memory in Depressed Mood

Recently, several studies have addressed the question of whether depression affects priming in implicit memory tasks. The main aim of this experiment was to assess the presence of a bias for negative information in explicit memory (free recall) and implicit memory (word-stem completion) tasks among subclinically depressed subjects compared to nondepressed subjects, using the typical levels of processing manipulation. The results of this study show the existence of a mood-congruent memory bias for both implicit and explicit memory in depressed subjects. The theoretical implications of these findings for implicit and explicit memory biases associated with depressed mood are discussed.     

TheP system: A scheme for organizing Pavlovian procedures

The present paper introduces theP system as a scheme for organizing Pavlovian procedures in an orderly and comprehensive manner. The system is defined by three temporal variables and three restrictions on their possible values. It can be used to define all standard temporal variables—namely, stimulus duration, interstimulus interval, trace interval, and intertrial interval—as well as variables C and T of scalar expectancy theory. The system also permits the definition of new independent variables through combinations of the basic temporal parameters. We exemplify this possibility by defining two ratios of temporal intervals. These ratios lead to a space where traditional Pavlovian arrangements (viz., simultaneous, forward-trace, forward-delay, backward) become points on a continuum, and optimal conditions across different experimental preparations become equivalent. Finally, the system can be used to define contingency variables such asp(US/CS),p(US/～CS), and the phi coefficient (φ). In this manner, an organization of different kinds of Pavlovian procedures is achieved on the basis of a single parametric scheme. Such an organization facilitates establishing procedural and theoretical relationships between temporal and contingency variables. The paper concludes with a discussion of certain limitations of the system and other related issues     

Latinas with Arthritis: Effects of Illness, Role Identity, and Competence on Psychological Well-Being

Tested a theoretical model on the effects of social role identity, illness intrusion, and competence on psychological well-being among 109 low-income Latinas with arthritis. All six roles studied were rated as highly important identities. Sex-role nontraditionalism was associated with less importance of the homemaker, mother, and grandmother roles. Negative affect increased as a function of intrusions into valued identities. Having important role identities contributed to feelings of competence (i.e., self-esteem and self-efficacy), which in turn, contributed to psychological well-being. Competence also mediated the effects of pain, identity, and illness intrusions on psychological well-being. Results suggest competence processes play an important role in well-being.     

An alternative assessment of children's comprehension of relative clauses

Methodological difficulties are identified in the assessment of children's comprehension of relative clauses (RCs) by means of the standard acting-out procedure. An alternative experimental task is proposed which attempts to minimize these difficulties while exploring the advantages of the acting-out technique. An experiment is reported in which Portuguese-speaking 3- to 6-year olds were tested by means of this alternative task. The results show children being affected by both the position and the focus of the RC in the same way adults have been reported to be and an error analysis suggests that most of children's difficulties can be ascribed to memory overload while RCs are processed as noun modifier sentences. These results contradict the view that there are developmental differences with regard to the way sentences with RCs are parsed and that processing load induces errors particularly manifested in right-branching subject focus sentences. Developmental changes taking place between the ages of 3 and 6 are considered and questions are raised concerning development from the age of 5.The research reported here was carried out while the author read for the PhD degree at the University of London. The writing up of this paper was financially supported by a postdoctoral grant from the Brazilian Research Council (CNPq: 302103-86.4).     

The functional role of attention for spatial coding in the Simon effect

Summary Two experiments investigated relative spatial coding in the Simon effect. It was hypothesized that relative spatial coding is carried out with reference to the position of the focus of visual attention. The spatial code for an imperative stimulus presented exactly at the position of focal attention should be neutral on the horizontal plane, and therefore no Simon effect should be observed. However, when the imperative stimulus is presented to the left or to the right of the current position of focal attention, the spatial code should not be neutral, thus producing a Simon effect. In both experiments, focal attention was manipulated either by a peripherally presented onset precue (Experiment 1) or by a centrally presented symbolic precue (Experiment 2). Results showed that the Simon effect was substantially reduced in both experiments when a valid precue preceded the imperative stimulus just in time to conclude refocusing of attention to the position of the imperative stimulus before it was presented. However, conditions with neutral precues yielded a normally sized Simon effect. In both experiments, the Simon effect decreased as the SOA grew when the precue was valid. At least for the Simon effect, the results can be interpreted as evidence that relative spatial coding is functionally related to the position of the focus of attention.     

A simplification of a result by zellini on the maximal rank of symmetric three-way arrays

Zellini (1979, Theorem 3.1) has shown how to decompose an arbitrary symmetric matrix of ordern ×n as a linear combination of 1/2n(n+1) fixed rank one matrices, thus constructing an explicit tensor basis for the set of symmetricn ×n matrices. Zellini's decomposition is based on properties of persymmetric matrices. In the present paper, a simplified tensor basis is given, by showing that a symmetric matrix can also be decomposed in terms of 1/2n(n+1) fixed binary matrices of rank one. The decomposition implies that ann ×n ×p array consisting ofp symmetricn ×n slabs has maximal rank 1/2n(n+1). Likewise, an unconstrained INDSCAL (symmetric CANDECOMP/PARAFAC) decomposition of such an array will yield a perfect fit in 1/2n(n+1) dimensions. When the fitting only pertains to the off-diagonal elements of the symmetric matrices, as is the case in a version of PARAFAC where communalities are involved, the maximal number of dimensions can be further reduced to 1/2n(n–1). However, when the saliences in INDSCAL are constrained to be nonnegative, the tensor basis result does not apply. In fact, it is shown that in this case the number of dimensions needed can be as large asp, the number of matrices analyzed.     

Authenticity as a foundational principle of medical ethics

Increasingly, contemporary medical ethicists have become aware of the need to explicate a foundation for their various models of applied ethics. Many of these theories are inspired by the apparent incompatibility of patient autonomy and provider beneficence. The principle of patient autonomy derives its current primacy to a large extent from its legal origins. However, this principle seems at odds with the clinical reality. In the bioethical literature, the notion of authenticity has been proposed as an alternative foundational principle to autonomy. This article examines this proposal in reference to various existentialist philosophers (Heidegger, Sartre, Camus and Marcel). It is concluded that the principle of autonomy fails to do what it is commonly supposed to do: provide a criterion of distinction that can be invoked to settle moral controversies between patients and providers. The existentialist concept of authenticity is more promising in at least one crucial respect: It acknowledges that the essence of human life disappears from sight if life's temporal character is reduced to a series of present decisions and actions. This also implies that the very quest for a criterion that allows physicians to distinguish between sudden, unexpected decisions of their patients to be or not to be respected, without recourse to the patient's past or future, is erroneous.