The Patient Self-Determination Act and Advance Directives: Snapshots of Activities in a Tertiary Health Care Center

This study describes the results of a retrospective review of patients' charts who had an advanced directive (AD) and who were hospitalized in a tertiary, acute care teaching hospital. The purpose of the review was to understand from clinical, sociological, ethical and legal perspectives the nature and utility of ADs. Findings and implications of the review are discussed in terms of: patient demographics; diagnoses; quality of ADs; influence of ADs on clinical decisions; and legal aspects of ADs.     

Enhancing Classroom Performance: A Review of Reinforcement Schedules

During the past decade the application of elementary principles of behavior have become a standard in the classroom teacher's repertoire of behavior change strategies. Unfortunately, the application of more advanced principles of behavior derived through basic behavioral research lies as an untapped resource for classroom teachers. Nowhere is this more apparent than in the use of systematic procedures to deliver reinforcers to enhance academic performance. In this paper we provide educators with information on the use of reinforcement schedules in academic settings. Various schedules of reinforcement are presented along with examples of their application in applied settings.     

Perceived fairness of biodata as a function of the purpose of the request for information and gender of the applicant

Using a 2×2 experimental design and data from 86 business students, the present study examined the main and interactive effects of the purpose of the request (personnel selection vs. career tracking), and applicant gender (male vs. female) on the perceived fairness of biodata. Results revealed a significant main effect for purpose and a purpose x gender interaction. Implications for the collection of biodata in the personnel selection process are discussed.     

Social Values and Relationships with Parents among American College Women of Chinese and European Descent

This study compared social values and relationships with parents among American college women of Chinese and European descent. Chinese-American women scored higher on a measure of practicality and pragmatism (mastery), hierarchy, and traditionality. The Euro-American women showed a greater interest in voluntary prosocial behaviour and philanthropy. Both groups of women reported having a sense of self, autonomous of their parents. Within the Chinese-American group, ethnic identification and religion, but not generation, moderated scores on a measure of traditionality of outlook regarding issues of law and order and social equality. We discuss the implications of our findings for recent debates in cross-cultural psychology, including the growing challenge to the individualism-collectivism dimension.     

A PRELIMINARY COMPARISON OF REINFORCER ASSESSMENT METHODS FOR CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER

We evaluated the relative treatment utility of a verbal forced-choice questionnaire, child nomination, and direct observation for identifying the most potent reinforcers for children with attention deficit hyperactivity disorder. Results demonstrated that all three methods were more likely to disagree than to agree, that a forced-choice format may enhance verbal reinforcer assessment, and that further development and evaluation of verbal reinforcer-assessment methods are needed.     

(My) spirituality in medical education

During these times of the situated, contingent text, it is not unusual for an author to disclose her biases and other sources of potential partiality as a researcher or theorist. That is, an author often discloses her race, class origins, or sexual orientation at the onset, announcing particularities that enable readers to adjust their reading to the subjectivities inherent to knowledge production. One glaring omission to these announcements, especially in medicine, has to do with the spiritual domain. This essay, written as a personal narrative, provides one example of how one's spirituality is connected to what and how one chooses to teach, even in the medical academy. Acknowledging those beliefs and considering how our spirituality (along with our other subjectivities that are known to us) may influence our work is an important process in developing a more reflective practice.     

The importance of stories in the act of caring

This article focuses on the essential role and function of story in the care of young children with emotional and behavioral disorders in an institutional setting. Highlighted in this article is the importance of story in the therapeutic relationship, its educational implications, and in theological reflection. A narrative approach of care becomes a way of healing both heart and mind, and is ultimately an act of love.     

Organizational factors in the effect of irrelevant speech: The role of spatial location and timing

Typically, hearing a repeated syllable produces minimal disruption of serial recall of visual lists, but a sequence of different syllables impairs performance markedly. Two conditions for presenting anidentical sequence of three syllables are compared: one, in which, by means of stereophony, each syllable is assigned to the left, center, or right auditory locus (three streamsnot changing in state), and another, in which the same syllable sequence occurs in one location only (one streamwith changing state). Disruption was significantly less in the stereophonic than in the monophonic condition. There was a joint effect of changing state and location, not an effect of the number of locations alone. In Experiment 2, temporal predictability was used to manipulate changing state. The disruptive effect ofregular presentation of a repeated syllable was markedly increased when it was presentedirregularly. The results are discussed in the context of organizational factors in short-term memory.     

Effects of learning contexts on implicit and explicit learning

Two parallel tasks involving rule learning were identified in Experiment 1A and were used to assess implicit and explicit learning. In both tasks, subjects had to input numbers in order to reach the target values of outputs. The relationship between inputs and outputs was either simple (in the simple task) or complex (in the complex task), and the way in which target values were presented could be in the form of either numbers (in the simple task) or lines (in the complex task). Experiment 1B examined the validity of the explicit measure in the complex task. Experiments 2–4 investigated the interaction between learning contexts and the simple/complex learning tasks. Verbalization and instructions to search for the rules facilitated the simple-task learning and hurt or have no effect on the complex-task learning. In the observational-learning condition, no learning occurred for the simple task, and the complex task learning was impaired. These results suggest that the complex task and simple task involve two distinct learning systems. Other implications are also discussed.     

The Diagnostic Interview Schedule for Children (PC-DISC v.3.0): Parents and Adolescents Suggest Reasons for Expecting Discrepant Answers

To identify reasons for discrepancies between parent and child reports of child/adolescents's psychiatric symptoms, parents and adolescents (51 pairs) were asked to guess what the other would answer to questions from the PC-DISC about the adolescent's psychiatric symptoms, and to explain why they expected disagreement when the answer they provided for the other was different from their own. Adolescents' explanations for expecting (1) parental denial of symptoms the adolescent reported were: the parent was unaware of, forgot about, assumed the adolescent could not have, or trivialized the symptom; and (2) parental report of symptoms the adolescent denied were: the parent misread or exaggerated the adolescent's symptom, had too high expectations for the adolescent's behavior, put a negative label on or did not trust the adolescent. Parents' reasons for expecting their children to (1) deny symptoms the parents reported were: the adolescent did not remember how s/he felt, lied, did not recognize or minimized the importance or frequency of the symptom; and (2) report symptoms the parents denied were: the adolescent lied, exaggerated the importance of or interpreted the symptom differently.Support for this work was provided by National Institute of Drug Abuse grant number DA-05585 (Dr. Cottler, P.I.), and National Institute of Mental Health grants numbers MH-31302 (Dr. R. C. Cloninger, P.I.) and MH-17104 (Dr. Cottler, P.I.).Address all correspondence, including reprint requests, to Michelle Bidaut-Russell, Ph.D, MPH, MPE, Department of Psychiatry, Box 8134, Washington University School of Medicine, 4940 Children's Place, St. Louis, Missouri 63110.