Adjustment to hemodialysis treatment through behavioral controls

The present study was conducted to examine the hypothesis that compliant chronically ill patients, typically described as adjusted, reinforce more positive social environments using behavioral controls than noncompliant patients, typically described as maladjusted. Specifically, it is hypothesized that diet-compliant chronic hemodialysis patients emit significnatly more active involvement-in-treatment behaviors and more social behaviors than diet-noncompliant chronic hemodialysis patients. Subjects, who ranged in age from 30 to 77 years, were outpatients at a kidney center. Behavioral observations were conducted to assess the occurrence or frequency of (1) four involvement-in-treatment behaviors that are routinely taught to all patients and (2) two social behaviors, which were patient verbalizations and smiles. The results showed that compliant patients emitted significantly more involvement-in-treatment behaviors and smiles than noncompliant patients. Results support the proposed control framework that compliant, in contrast to non-compliant, chronically ill patients have recourse through positive behavioral controls when adjusting to the stresses of illness. It was proposed that through these controls, compliant patients reinforce positive environments rather than simply respond to life circumstances as given.     

PRIMARY ENCOPRESIS: EVALUATION AND TREATMENT

Cathartic and behavioral treatment procedures for eliminating diurnal and nocturnal primary encopresis were investigated using a multiple-baseline design across four children. The dependent and independent variables measured were appropriate bowel movements, soiling accidents, independent toiletings, and cathartic use. Over 177 reliability observations (home visits) were conducted. For two of the children, treatment with cathartics and child-time remedied their soiling accidents and increased their independent toiletings in 8 to 11 weeks. While the cathartics and child-time increased the rate of appropriate bowel movements, they did not eliminate the soiling accidents with the other two children. Independent toiletings for these two children were achieved after 32 to 39 weeks of treatment when punishment procedures (positive practice, time-out, and hourly toilet sits) were incorporated and the suppositories were faded systematically.     

The role of phonemes and syllables in the perceived similarity of speech sounds for children

In two experiments, we investigated the factors that influence the perceived similarity of speech sounds at two developmental levels. Kindergartners and second graders were asked to classify nonsense words, which were related by syllable and phoneme correspondences. The results support the existence of a developmental trend toward increased attention to individual phonemic segments. Moreover, one significant factor in determining the perceived similarity of speech sounds appears to be the position of the component correspondences; attention to the beginning of utterances may have developmental priority. An unexpected finding was that the linguistic status of the unit involved in a correspondence (whether it was a syllable or a phoneme) did not seem particularly important. Apparently, the factors which contribute to the perceived similarity of speech sounds in the classification task are not identical to those which underlie performance in explicit segmentation and manipulation tasks, since in the latter sort of task, syllables are more accessible than phonemes for young children. The present task may tap a level of processing that is closer to the one entailed in word recognition and lexical access.     

Sex role stereotyping in the sunday comics: Ten years later

The present research replicates Brabant's (Sex role stereotyping in the Sunday comics. Sex Roles, 1976, 2(4), 331–337) analysis of sex role stereotyping in family-oriented Sunday comics. Cartoons were collected for the same six-month period and compared to the 1974 data. Females continue to appear less frequently and to remain in the home more often than males. They also continue to be protrayed in stereotypical roles.     

Spontaneous versus instructed use of multiple standards for evaluating comprehension: Effects of age,reading proficiency,and type of standard

Nine- and eleven-year-old children differing in reading proficiency read and commented on brief expository passages containing three different types of embedded problems (nonsense words, prior knowledge violations, and internal inconsistencies). Half of the children were specifically instructed as to the types of standards they should apply in order to detect the problems (lexical, external consistency, and internal consistency); the remaining children were simply instructed to look for problems. Both quantitative and qualitative differences in standard use were revealed by the children's comments about all parts of the passages. Older and better readers used more different standards and they used them more frequently than younger and poorer readers. The lexical standard was more likely to be adopted spontaneously than the other two standards and it was the only standard used by a substantial proportion of both younger and poorer readers. Finally, the consistent effects of instruction type indicate that children's evaluation activities were strongly influenced by the amount of guidance received.     

A comparison of monocular and binocular depth perception in 5- and 7-month-old infants

Monocular depth perception was compared with binocular depth perception in 5- and 7-month-old infants. Reaching was used as the dependent measure. Two objects, identical except in size, were presented simultaneously to each infant. The smaller object was within reach for the infants while the larger object was just beyond reach. The two objects subtended equal visual angles from the infants' observation point. With binocular presentation, 96% of the 7-month-olds' reaches and 89% of the 5-month-olds' reaches were for the nearer object. With monocular presentation, 58% of the 7-month-olds' reaches and 65% of the 5-month-olds' reaches were for the nearer object. The reaching preferences observed in the monocular condition indicated sensitivity to monocular depth information (motion parallax, accommodation, and relative size information were available). Binocular viewing, however, resulted in a far more consistent tendency to reach for the nearer object. This result suggests that the infants' perception of the objects' distances was more veridical in the binocular condition than in the monocular condition.     

The relationship of sex-role stereotypy to anger expression and the report of psychosomatic symptoms

The purpose of this investigation was to assess the relationship between selected psychological and behavioral measures concenred with the expression of anger and the report of psychosomatic symptoms. Presumably healthy college students filled out a symptom inventory which served as the criterion measure. Additionally, questionnaires were used to measure sex-role stereotypy, assertiveness, various types of hostility, and hostility guilt, which were then employed in a series of related analyses. Results supporting predicted relationships consistently demonstrated a positive association between the number of symptoms and indirect expression of anger as well as certain stereotypically feminine traits. Significant negative correlations were found between the symptom measure and assertiveness and between the symptom measure and scores on masculinity scales. Predictions that symptom frequency would be negatively related to the direct expression of hostility and positively related to hostility-guilt were not supported.     

Reframing caring for parents who struggle with substance-use disorders

Nancy Suchman and the colleagues she influenced have produced ground-breaking and attitude-challenging work in understanding how parenting and substance use come together. Dr Suchman and her colleagues make the claim that there is nothing about a substance-use disorder that precludes effective and sensitive caring for children especially with interventions that focus on the parent–child relationship. Suchman's legacy is to highlight how substance use as an illness pulls individuals away from important, caring relationships and limits their giving themselves to those relationships. Restoring the salience of caring relationships and of the individual's ability to care may be as impactful on their substance use as a strict focus on the reduction of drug use and achieving abstinence.     

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.