Medical education in a community model of care: The future of medical education in a large academic community hospital

Profound changes in the practice of medicine have led to new demands on the profession and on the process of medical education. In recognition of the expanded role of a physician as a professional responsible for the welfare of individuals, Lehigh Valley Hospital has developed an ambitious, innovative Strategic Plan for Education. The plan entitled, Medical Education in a Community Model of Care, emphasizes the organizational importance of education in the hospital's achievement of its mission of community service. The Strategic Plan for Education is community focused. In addition to its primary role of serving its local community, the plan is intended as a educational model for organizations in other parts of the country.Preparation of this paper was supported by a grant from the Dorothy Rider Pool Health Care Trust.     

Origins of a stereotype: categorization of facial attractiveness by 6-month-old infants

Like adults, young infants prefer attractive to unattractive faces (e.g. Langlois, Roggman, Casey, Ritter, Rieser‐Danner & Jenkins, 1987 ; Slater, von der Schulenburg, Brown, Badenoch, Butterworth, Parsons & Samuels, 1998 ). Older children and adults stereotype based on facial attractiveness ( Eagly, Ashmore, Makhijani & Longo, 1991 ; Langlois, Kalakanis, Rubenstein, Larson, Hallam & Smooth, 2000 ). How do preferences for attractive faces develop into stereotypes? Several theories of stereotyping posit that categorization of groups is necessary before positive and negative traits can become linked to the groups (e.g. Tajfel, Billig, Bundy & Flament, 1971 ; Zebrowitz‐McArthur, 1982 ). We investigated whether or not 6‐month‐old infants can categorize faces as attractive or unattractive. In Experiment 1, we familiarized infants to unattractive female faces; in Experiment 2, we familiarized infants to attractive female faces and tested both groups of infants on novel faces from the familiar or novel attractiveness category. Results showed that 6‐month‐olds categorized attractive and unattractive female faces into two different groups of faces. Experiments 3 and 4 confirmed that infants could discriminate among the faces used in Experiments 1 and 2, and therefore categorized the faces based on their similarities in attractiveness rather than because they could not differentiate among the faces. These findings suggest that categorization of facial attractiveness may underlie the development of the ‘beauty is good’ stereotype.     

Sex differences in attributions and learned helplessness

This investigation assessed the hypothesis that girls are more likely to be learned helpless in math than boys. Students in grades 5 through 11 completed questionnaires assessing their causal attributions for success and failure in mathematics, their self-concepts of math ability, and their expectations for both current and future success in math. Results indicated that sex differences in attributions depended on the type of methodology used (open-ended or rank-ordered questions). The most consistent difference involved the differential use and ranking of ability, skills, and consistent effort. No sex differences were found in either students' perceptions of their own math ability or in their current achievement expectations. Girls, however, rated their future expectations slightly lower than did boys. Taken together, these results provide little support for the hypothesis that girls are generally more learned helpless in mathematics than are boys.     

The effect of social cues on the eating behavior of obese and normal subjects1

Schachter's externality hypothesis suggests that overweight individuals are more likely to be induced to eat by salient external cues than normal weight individuals. While a range of studies have demonstrated the plausibility of this hypothesis in the case of sensory stimuli (e.g., taste cues), there is little evidence that the hypothesis applies to social stimuli. The current study examines this latter proposition by exposing male and female, overweight and normal weight subjects to a same-sex or opposite-sex peer model. Under the guise of engaging in a taste experiment, the subjects were either exposed to a model who tasted experiment, the subjects were either exposed to a model who tasted no crackers (no eat), one cracker (low eat), or twenty crackers (high eat). In addition, control model-absent conditions were also run for purposes of establishing baseline eating rates. If the externality hypotheses were to prevail in social domains, one would expect overweight subjects to be more prone to model the cracker-eating behavior of the peer than normal weight individuals. However, the findings indicate that all subject groups regardless of weight evidence a rather clear modeling effect and all subjects evidence social inhibition effects on their eating behavior as well. Several intriguing interactions among subject sex, model sex, subject weight, and social condition were also found. The discussion explores the relevance of an externality model of overweight eating in social domains, and focuses upon the interesting and somewhat distinct pattern of socially mediated eating exhibited by overweight females.     

On the nature of the span of apprehension

Summary Typically, people can only report about four or five items from a briefly presented array of alphanumeric items. A new span task was used to explore the basis of this limitation. In Experiment l, performance suffered when very brief display durations were combined with a verbal-load task, but no significant effects of display duration were found when there was no verbal load. In Experiment 2, a similar interaction was observed between verbal load and the presence of a visual suffix; performance was worse in the verbal-load condition with a visual suffix, but no such effect was observed without verbal load. In both experiments, poorer performance was associated with enhanced serial-position effects. The results can be explained on the assumption that the verbal-load task required some processing resources, and that the quality of information in visual working memory depends on available resources. Thus, both brief-array presentation and the visual suffix degrade the information in visual working memory, but span performance is impaired only when processing resources are relatively scarce.     

Negation: A rejoinder to Wales and Grieve

Wales and Grieve (1969) report an experiment in which they show that a factor of “confusability” affects the comprehension of affirmative and negative sentences, and then claim that this is a relevant factor in explaining the difficulty of negatives. The present paper submits arguments and experimental evidence to dispute this claim.     

Treatment of Maternal Depression With In-Home Cognitive Behavioral Therapy Augmented by a Parenting Enhancement: A Case Report

Depression is prevalent among mothers who participate in home visitation programs. This case study describes In-Home Cognitive Behavioral Therapy (IH-CBT), an empirically based treatment for depressed mothers that is strongly integrated with ongoing home visitation. The use of a Parenting Enhancement for Maternal Depression (PEMD) module was added to address parenting difficulties in a depressed mother. This case describes issues and challenges encountered in delivering treatment in the home with low-income, depressed mothers. Issues involving engagement, adaptation to the setting, responding to the unique needs of low-income mothers, and partnership with concurrent home visiting to optimize outcomes are considered. Long-term follow-up (18 months after the end of treatment) permits examination of sustainability of gains. Implications for treating this high-risk population are discussed.     

Bodily centered protections in adolescence: An extension of the work of Frances Tustin

In this paper, the author discusses the recurrence of infantile, proto-mental functioning in adolescence mainly in the context of the work of Frances Tustin. She demonstrates, through clinical example, how the tendency to resort to bodily centered and sensation-dominated protections is reactivated on a grand scale when the internal and external physical and psychological changes, brought on in puberty, are felt to be potentially overwhelming. She also demonstrates how, when the capacity for adequate mental and emotional development is stultified, sensation and action once again come to the rescue as the adolescent's way of attenuating anxieties unconsciously experienced as resonating with those unmentalized happenings of early infancy and how the psychoanalytic relationship may be pivotal in setting previously derailed mental and emotional growth back on track.