Extreme Social Isolation, Use of Community-Based Senior Support Services, and Mortality Among African American Elderly Women

The effect of extreme social isolation and use of community-based senior services on longevity was examined in a national sample of African American elderly women (ages 55–96). Consistent with previous research on the social integration/mortality link, African American elderly women who were extremely socially isolated were hypothesized to have a higher 5-year mortality rate. It was also hypothesized that use of community senior services would be negatively associated with 5-year mortality. Results of logistic regression analysis controlling for age, education, income, and health status found that extremely socially isolated African American elderly women were three times more likely than the nonisolated women to die within the 5-year period from the initial survey. Use of community senior services did not have a relationship on mortality. Results are discussed in terms of directions for future research and intervention.     

Object knowledge and the emergence of language

Infants' spontaneous play with objects was examined for evidence of developments in object knowledge in relation to the emergence of words and the single-word period in language development. Subjects were 7 girls and 7 boys, from different ethnic and economic backgrounds, who were studied longitudinally from 9 months to 26 months of age. Two types of displacements of objects in relation to one another were identified in the children's play: separations and constructions. The development of constructions was associated with the emergence of words, and constructions increased with age while separations decreased. The development of specific constructions, which account for knowledge of the particular properties of objects, was more strongly associated with a vocabulary spurt at the end of the single-word period than with chronological age. Despite the wide variation in the infants' ages when developments in language and play were reached, relations between achievements in the two domains were consistent among them, as confirmed with the Friedman test, p<.001. The results are discussed in terms of the cognitive developments required for play with objects and saying words.     

Practical knowledge and the subjectivity of truth in Kant and Kierkegaard: The cover of skepticism

Kant developed a distinctive method of philosophical argumentation, the method of transcendental argumentation, which continues to have contemporary philosophical promise. Yet there is considerable disagreement among Kant's interpreters concerning the aim of transcendental arguments. On ambitious interpretations, transcendental arguments aim to establish certain necessary features of the world from the conditions of our thinking about or experiencing the world; they are world‐directed. On modest interpretations, transcendental arguments aim to show that certain beliefs have a special status that renders them invulnerable to skeptical doubts; they are belief‐directed. This paper brings Kierkegaard's thesis of the “subjectivity of truth” to bear on these questions concerning the aim of transcendental arguments. I focus on Kant's argument for the postulate of God's existence in his Critique of Practical Reason and show that Kierkegaard's thesis of the subjectivity of truth can help us construe the argument as both belief and world directed. Yet I also argue that Kierkegaard's thesis of the subjectivity of truth can help us understand the source of our dissatisfaction with Kant's transcendental arguments: It can help us understand that dissatisfaction as an expression of what Stanley Cavell calls the “cover of skepticism,” the conversion of metaphysical finitude into intellectual lack.     

Training Methods for Delivering Difficult News in Genetic Counseling and Genetics Residency Training Programs

Genetic counselors and clinical geneticists are often in the position of delivering difficult news (DDN) to patients and families. Many studies show that healthcare providers require major improvement in the skills needed in DDN in a manner that is satisfactory to their patients. The purpose of this study was to assess the amount and methodology of DDN training received by genetic counselors and medical genetics residents in their training programs, such as observations of DDN or attending didactic lectures. To our knowledge, there is no previous assessment or study of DDN training in genetic counselor and medical genetics residency programs; therefore, we aim to both assess and compare the training in DDN received by genetic counselors and by genetics residents and determine whether there is a desire for recommendations on DDN training. We invited genetic counseling (GC) and genetics residency program directors to participate in an online survey designed to assess coursework, clinical experiences, and directors’ attitudes toward teaching DDN. Response rate was 85% (28/33) for GC program directors and 26% (14/53) for genetics residency program directors. One hundred percent of GC and genetics residency directors who responded to the survey agreed that it is important for genetic counselors and medical geneticists to be able to deliver difficult news effectively and that training programs should formally teach students how to deliver difficult news. Six of the eight common teaching methods are used by at least 75% of GC programs while two of eight are used by at least 75% of genetics residency programs. Seventy-nine percent of GC and 93% of genetics residency program directors agree that there should be recommendations on how to teach students to deliver this news. Our results show that techniques for DDN are integrated more fully into GC program curricula than genetics residency curricula. Directors of both types of programs desire recommendations and more standardized education for training students to deliver difficult news.     

Special Considerations in the Adaptation of Cognitive Behavioral Therapy for Insomnia With Active-Duty U.S. Army Personnel

Insomnia is highly prevalent among active-duty military service members. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a well-established and effective treatment; however, research and treatment recommendations have primarily focused on civilian or veteran populations. A multitude of military-specific factors directly impact service members’ sleep and the subsequent treatment recommendations. This article provides treatment considerations for the use of CBT-I with active-duty U.S. Army personnel. First, an overview of the theoretical model of insomnia, including military-specific predisposing, precipitating, and perpetuating factors, is presented, followed by a review of common comorbid conditions among service members with insomnia. Finally, discussion focuses on considerations and strategies for implementing components of CBT-I with service members, managing sleep during deployments, and adjusting sleep to accommodate overnight duties. Additional training resources and supplemental video examples (with actors) are provided.     

Infant recall memory and communication predicts later cognitive development

This longitudinal study investigates the relation between recall memory and communication in infancy and later cognitive development. Twenty-six typically developing Swedish children were tested during infancy for deferred imitation (memory), joint attention (JA), and requesting (nonverbal communication); they also were tested during childhood for language and cognitive competence. Results showed that infants with low performance on both deferred imitation at 9 months and joint attention at 14 months obtained a significantly lower score on a test of cognitive abilities at 4 years of age. This long-term prediction from preverbal infancy to childhood cognition is of interest both to developmental theory and to practice.     

Age deficits in the control of prepotent responses: evidence for an inhibitory decline

Older adults have more difficulty than younger adults appropriately directing their behavior when the required response is in competition with a prepotent response. The authors varied the difficulty of inhibiting a prepotent eye movement response by varying the response cue (peripheral onset or central arrow). The response cue manipulation did not affect prosaccade accuracy and latency for either age group and did not affect younger adults' antisaccades. Older adults' antisaccades were slower in the peripheral cue condition than in the central arrow condition. These findings are taken as support for the inhibitory deficit hypothesis of aging (L. Hasher, R. T. Zacks, & C. P. May, 1999).     

The poehlman case: running away from the truth

Eric T. Poehlman, Ph.D., was an internationally recognized, tenured professor at the University of Vermont (UVM) in Burlington when, in October 2000, a junior member of Poehlman’s laboratory became convinced that he had altered data from a study on aging volunteers from the Burlington area. This suspicion developed into one of the most significant cases of scientific misconduct in the history of the US Department of Health and Human Services’ (HHS) Office of Research Integrity (ORI), launching a US Department of Justice (DOJ) civil and criminal fraud investigation and, eventually, to a much publicized guilty plea and felony conviction. In the end, Dr. Poehlman admitted to 54 findings of scientific misconduct made by the UVM and ORI, agreed to retract or correct ten of his publications and to exclude himself from federal procurement and nonprocurement transactions for life. The United States Government’s handling of this case was distinguished by a highly cooperative approach that integrated the resources of the US Attorney’s Office for the District of Vermont (USAO) and both ORI and the Office of the Inspector General (OIG) in HHS in the common goal of prosecuting research fraud. The content of this article represents the personal views of the authors and does not express the opinion or policy of DHHS or its components. A paper on this topic was presented at the 6th International Bioethics Conference on the subject of ‘The Responsible Conduct of Basic and Clinical Research’, held in Warsaw, Poland, 3–4 June 2005.     

Developmental dyscalculia and basic numerical capacities: a study of 8-9-year-old students

Thirty-one 8- and 9-year-old children selected for dyscalculia, reading difficulties or both, were compared to controls on a range of basic number processing tasks. Children with dyscalculia only had impaired performance on the tasks despite high-average performance on tests of IQ, vocabulary and working memory tasks. Children with reading disability were mildly impaired only on tasks that involved articulation, while children with both disorders showed a pattern of numerical disability similar to that of the dyscalculic group, with no special features consequent on their reading or language deficits. We conclude that dyscalculia is the result of specific disabilities in basic numerical processing, rather than the consequence of deficits in other cognitive abilities.