The question is: what is medicine supposed to be all about?

The Hippocratic Oath has survived, with overriding power, the test of time. Written somewhere between 600 B.C. and 100 A.D., it addresses the intrinsic nature of medicine. Even those of us who know little of it or reject parts of it acknowledge it to be a symbol of the values of medicine. Such "canonization" is unlikely to be arbitrary; it is more likely that the oath strikes some key chord of truth. I suggest that it is its drive to the heart of medicine that makes the Hippocratic Oath inspiring today.     

Ethics in health care and medical technologies

In this paper a case is used to demonstrate how ethical analysis enables health care professionals, patients and family members to make treatment decisions which ensure that medical technologies are used in the overall best interests of the patient. The claim is made and defended that ethical analysis can secure four beneficial outcomes when medical technologies are employed: (1) not allowing any medical technologies to be employed until the appropriate decision makers are identified and consulted; (2) insisting that medical technologies be employed not merely to promote the medical interests of the patient but rather on the basis of their ability to contribute to the overall well-being of the patient; (3) challenging caregivers to reflect on the dynamic interplay between their conscious and unconscious values and consequent determinations of what is in the patient's best interests; and (4) providing a justification for selected interventions which makes possible rational dialogue between caregivers espousing different viewpoints about treatment options.     

Young infants’ perception of liquid coarticulatory influences on following stop consonants

Phonetic segments are coarticulated in speech. Accordingly, the articulatory and acoustic properties of the speech signal during the time frame traditionally identified with a given phoneme are highly context-sensitive. For example, due to carryover coarticulation, the front tongue-tip position for HI results in more fronted tongue-body contact for a /g/ preceded by /l/ than for a /g/ preceded by /r/. Perception by mature listeners shows a complementary sensitivity—when a synthetic /da/-/ga/ continuum is preceded by either /al/ or /ar/, adults hear more /g/s following HI rather than Irl. That is, some of the fronting information in the temporal domain of the stop is perceptually attributed to /l/ (Mann, 1980). We replicated this finding and extended it to a signaldetection test of discrimination with adults, using triads of disyllables. Three equidistant items from a /da/-/ga/ continuum were used preceded by /al/ and /ar/. In the identification test, adults had identified item ga5 as “ga”, and dal as “da”, following both /al/ and /ar/, whereas they identified the crucial item d/ga3 predominantly as “ga” after /al/ but as “da” after /ar/. In the discrimination test, they discriminated d/ga3 from dal preceded by /al/ but not /ar/; compatibly, they discriminated d/ga3 readily from ga5 preceded by /ar/ but poorly preceded by /al/. We obtained similar results with 4-month-old infants. Following habituation to either ald/ga3 or ard/ga3, infants heard either the corresponding ga5 or dal disyllable. As predicted, the infants discrimi-nated d/ga3 from dal following /al/ but not /ar/; conversely, they discriminated d/ga3 from ga5 following /ar/ but not /al/. The results suggest that prelinguistic infants disentangle consonant-consonant coarticulatory influences in speech in an adult-like fashion.     

PIGEONS ARE SENSITIVE TO THE SPATIAL ORGANIZATION OF COMPLEX VISUAL STIMULI

Abstract— Two experiments investigated the role of spatial organisation in the discrimination and generalization of complex visual stimuli by pigeons. In Experiment 1, after pigeons had been trained to discriminate line drawings of four objects, they were tested with novel pictures in which the same component parts of the objects were spatially rearranged. The spatially scrambled pictures led to a dramatic drop in recognition accuracy, hut responding remained above chance. In Experiment 2, pigeons reached a high level of discriminative performance when required to choose among four different spatial arrangements of the same object parts. These results confirm Cerella's (1980) conclusion that pigeons discriminate the component parts of complex visual stimuli, but. unless it is assumed that the scrambling deleted or created emergent features, the results disconfirm his conclusion that spatial organization plays no role in pigeons' picture perception.     

Interrelationships among students' study activities,self-concept of academic ability,and achievement as a function of characteristics of high-school biology courses

This investigation focused on the interrelationships among students' study activities, students' self-concept of academic ability ratings, students' academic achievement, and instructional practices in 12 high school biology courses. Using a framework derived from a previous investigation, course features were classified into those that appear to (a) place demands on, (b) support, or (c) compensate for student engagement in particular study activities. Students' study activities, self-concept of academic ability ratings, and achievement were measured with experimenter-developed instruments. Results are reported for (a) characteristics of instruments and course features, (b) relationships between central factors of the investigation, and (c) multi-level relationships between course features and student variables. Results at the student level indicated that self-concept of academic ability and, to a lesser extent, students' study activities were positively associated with student achievement. Students' self-concept of academic ability ratings were also linked to students' engagement in generative, proactive study activities. At the course level the supportive practices of providing challenging homework assignments and extensive feedback on student coursework were associated with student engagement in effortful, generative, proactive study activities. The provision of extensive feedback was also associated with high student achievement. Multi-level relationships were analysed using hierarchical linear modelling (HLM) analyses. These analyses revealed, for example, that in courses in which little or no feedback is given on homework assignments, the relationship between achievement and student engagement in diligent effort management activities was enhanced. Other HLM analyses were conducted to examine the mediating role of course features on the relationship between students' self-concept of academic ability and their study activities and achievement. For example, the presence of challenging course demands was associated with an enhancement of the relationship between self-concept of academic ability and achievement whereas the presence of instructor provisions (supports and compensations) designed to reduce course demands was associated with a reduction in this relationship.     

Effects of Race,Racial Identity Development,and Orientation Style on Perceived Consultant Effectiveness

This study explores Black teachers' preferences for and ratings of consultant effectiveness as a function of consultant race, consultant style, and teacher stage of racial identity development. No significant differences were noted in preferences for either a same- or opposite-race consultant. Participants preferred and rated as more effective an instrumentally oriented consultant.     

Offering predictive testing for Huntington disease in a medical genetics clinic: Practical applications

Predictive testing for Huntington disease is presently offered in a select few medical genetics centers in the United States. This is in part due to the labor intensive counseling and psychological testing suggested by the research protocols. We discuss some specific suggestions for establishing programs for Huntington disease predictive testing within pre-existing medical genetics clinics to encourage more centers to offer presymptomatic testing. This will allow more at risk individuals the opportunity to consider predictive testing and cut down the expenses of traveling to the few predictive testing centers that currently exist. The counseling principals will remain similar to those discussed here, even following the identification of the Huntington disease mutation.     

Family preservation using multisystemic treatment: Long-term follow-up to a clinical trial with serious juvenile offenders

In a randomized clinical trial, multisystemic family preservation was shown to significantly reduce rates of criminal activity and incarceration in a sample of 84 serious juvenile offenders and their multi-need families. In the current study, archival records were searched for re-arrest an average of 2.4 years post-referral. Survival analysis showed that youths who received multisystemic family preservation were less likely to be re-arrested than were youths who had received usual services. Such results represent the first controlled demonstration that family preservation, when delivered via a clearly specified treatment model, has lasting effects with serious juvenile offenders. Implications for family preservation and juvenile justice research are discussed.     

Nonsuicidal physically self-damaging acts in adolescents

To determine the frequency and correlates of nonsuicidal physically self-damaging acts in 12–14 year olds, a two stage epidemiologic survey with a self-administered questionnaire (N=3283) followed by a psychiatric interview of a subsample of the adolescents and their parents (N=444) was used. Prevalence estimates of interview validated nonsuicidal physically self-damaging acts were 2.46% in males and 2.79% in females. Significant relationships were found between nonsuicidal physically self-damaging acts and suicidal ideation, major depression and undesirable life events. Data suggest that physically self-damaging acts occur at substantial rates during early adolescence. The strong correlation between nonsuicidal self-destructive acts and both suicidal ideation and major depression clarifies prior conflicting reports in the literature and suggests that a history of self-damaging acts should be taken into consideration when evaluating for possible depression and suicide risk.