Jewish medical ethics in the care of the cancer patient

The care of the patient with cancer requires the development not only of a medical plan, but an ethical plan as well. This plan should integrate the physician's and the patient's perceptions of medical and ethical propriety. Jewish biomedical ethical principles are based on the teaching of the Old Testament and its various interpretations. In this paper, I discuss how these principles can be used to help guide the physician caring for the patient with cancer. Other ethical systems could be applied in a similar fashion.     

The assessment of child abuse potential and the prevention of child abuse and neglect: A policy analysis

A frequently advocated strategy for increasing the efficiency of child abuse prevention programs is to deliver prevention services to "high-risk" populations. This article critically reviews procedures for the reliable and valid assessment of child abuse potential within an ecological perspective. Factors that limit the usefulness of child abuse risk assessment are discussed. These factors include the uncertain criteria of child abuse and neglect, the low base rate of the phenomenon, and the financial and social costs of such procedures. Finally, the prevention implications of the current and future state of the art in child abuse risk assessment are considered and preventive interventions that do not depend on individual case risk screening are advocated.     

Feasibility of validating survey self-reports of mental health service use

Survey respondents may inaccurately report mental health service utilization for motivational and cognitive reasons. There is little evidence on accuracy of self-reports of mental health service use, and this evidence suggests that respondents tend to underreport inpatient utilization. This study addressed the question of self-report accuracy by comparing survey data from a large probability sample to data from computerized records of publicly funded mental health services. Few inaccuracies in self-reporting were detected. However, despite the use of data bases that were unusually appropriate for verifying self-reports, several problems limited the feasibility of validation. Suggestions are offered for increasing the feasibility of validation in future studies.     

The social supports of suicide attempters: The different roles of family and friends

The social support patterns of a sample of 101 suicide attempters were compared with the patterns of a control sample on the basis of structured interview data. Network characteristics and the extent of support in different functional categories were examined as to their absolute and relative power to discriminate between the suicide attempters and the controls. A clear separation of the functions of kin and of friends/acquaintances emerged. The crucial difference between the attempters and the controls lay in the number of friends with whom the subjects had agreeable everyday interactions and in the number of kin that provided crisis support, both psychological and instrumental. Other support differences between the two groups were of secondary importance. While there was no overall difference in the frequency of social interactions between the two groups, the size of the social network differed greatly. Consequences for the conceptualization and measurement of social support as well as for the prevention of suicidal behavior are discussed.     

Processing resources and age differences in working memory

This study investigated the performance of young and old subjects on a modified version of the working memory task developed by Baddeley and Hitch (1974). Subjects were required to verify a set of sentences of varying complexity while they repeated aloud zero, two, or four words. The older subjects took longer to verify the sentences, especially when the sentences were grammatically complex, but the effect of concurrent memory load on verification latency was the same in both groups. These results cast doubt on the notion that there is an age-related decline in one general pool of processing resources. They also suggest that older people have greater difficulty with the active processing aspects, rather than with the passive holding aspects, of working memory tasks.     

Hindsight bias: An interaction of automatic and motivational factors?

If subjects are asked to recollect a former response after having been informed about the correct response, their recollection tends to approach the correct response. This effect has been termedhindsight bias. We studied hindsight bias in an experiment requiring numerical responses to almanac-type questions for physical quantities. We varied (1) the time at which the correct information was provided, (2) the encoding of the original responses by asking/not asking subjects to give a reason for the respective response, and (3) the motivation to recall correctly. We found that hindsight is less biased if reasons are given and if the correct information is provided at an earlier time. Motivation had only interactive effects: (1) With high motivation to recall correctly, the time the correct information was provided had no influence. (2) With reasons given, the variation of motivation showed no effect. These results rule out purely motivational and purely automatic explanations.     

Individual differences in vocal activity rhythm: Fourier analysis of cyclicity in amount of talk

Speakers in informal conversations tend to alternate regularly between lower and higher amounts of talking; the periods of these low/high activity cycles are on the order of 3, 6, and 15 minutes. Statistically significant periodicities occurred in 55% of the conversations studied. The periodograms that describe the partition of variance among periodic components whow consistent individual differences in the cyclic patterning of vocal activity. Discriminant analysis used the amount of variance accounted for by each of the 12 lowest-frequency periodic components as discriminating variables to see whether speakers could be identified on the basis of the cyclic patterns in vocal activity. Speakers were discriminated and classified at levels well above chance. This suggests that there are consistent individual differences among speakers in the length of cycles in amount of talk.We gratefully acknowledge support from the Central University Research Fund and from the office of the Dean of Liberal Arts at the University of New Hampshire.     

Spatial coding in the processing of anaphor by good and poor readers: Evidence from eye movement analyses

An experiment that examined the way in which young readers deployed eye movements while reading sentences and while answering questions containing either a pronominal or noun anaphor is reported. To evaluate the possible causal role played by differences in inspection strategies between readers of above- and below-average reading skill, a third“age control” group of younger children was also tested. This group was matched on absolute reading ability with the less skilled group of older children, and on relative reading ability (i.e. reading quotient) with the more skilled group. Differences in inspection strategy were apparent between the groups of good and poor readers. Good readers launched more selective reinspections, whereas the poorer readers were more inclined to engage in“backtracking” and appeared to make less use of the displayed text. In every case there was a marked similarity in the behaviour of the good readers and the“age controls”. These results suggest that the ability to code the spatial location of words in a sentence, and, where necessary, to use this information to launch accurately targetted selective reinspections of previously read text, plays a crucial role in the development of skilled reading performance.