Evaluation of an islandwide screening,assessment and treatment program

This article reports on the effectiveness of the Islandwide Screening, Assessment, and Treatment Program of the Child Development Project in Bermuda. From 1982 to 1984, approximately 1100 families with 2-year-old children were screened for children's cognitive and language delay, for behaviour management problems and for other home characteristics that put children at risk for later school failure. Children who failed the screening and subsequent assessment procedures (of whom random samples received treatment) and samples of others who passed screening and assessment were evaluated from 1984 to 1986 at 4 years of age. This article focuses on the results of the cognitive and language programs; the more problematic behaviour management analyses were reported elsewhere (Miller and Scarr, 1988). The screening procedures and assessment measures developed for this project were themselves evaluated and adjusted to maximize efficiency and costeffectiveness. The screening and assessment procedures proved effective in bringing to the attention of the Child Development Project those families and children who need developmental services, and in not overidentifying normal children as potentially delayed in development. Two kinds of treatment services were compared: The Mother-Child Home Program (MCHP), administered by paraprofessional toy demonstrators, and other interventions tailored by professionals to the language and cognitive problems of the child (called ‘tailored programs’). Children who were not extremely delayed or disturbed were randomly assigned either to the MCHP or to a tailored program. Neither intervention program was preferable to the other. Even though improved, the 4-year-olds identified as developmentally delayed at 24 months still lagged behind children who passed all parts of screening and those who failed screening but passed assessment 2 years earlier. The screening and assessment procedures were very effective in the early identification of children with developmental problems, but the treatment programs failed to bring most children to normal levels of cognitive and language functioning.     

Sentence comprehension by Broca's aphasics: Effects of some suprasegmental variables

Three subtests of comprehension (one of varying sentential stress, one of shifting juncture, and one of applying emphatic stress to functors) were administered to eight Broca's aphasics and eight controls to determine the effects of stress and juncture on disambiguation of these sentences. Data indicated that the aphasic group performed significantly worse than the normals on all three subtests of comprehension. In addition, there was a strong positive correlation between severity of aphasia and error scores for all three tests. Results are discussed in relation to intact-vs.-disordered comprehension.     

Plausibility and argument structure in sentence comprehension

In two experiments, we investigated how reading time was affected by the plausibility of the prepositional phrase in subject-verb-noun-phrase-prepositional-phrase sentences, and the status of the prepositional phrase as argument versus adjunct of the verb. Highly plausible prepositional phrases were read faster than less plausible ones, and argument prepositional phrases were read faster than adjuncts. These effects appeared both in a self-paced reading experiment and in an experiment that measured eye movements during normal reading. The effects of plausibility were substantially larger and longer lasting than the effects of argument status, but both appeared very early in the reading of the prepositional phrase. The implications of these effects for models of parsing and sentence interpretation are discussed.     

Production of Stress Retraction by Left- and Right-Hemisphere-Damaged Patients

An acoustic-perceptual investigation of a phonological phenomenon in which stress is retracted in double-stressed words (e.g., thirTEEN vs THIRteen MEN) was undertaken to identify the locus of functional impairments in speech prosody. Subjects included left-hemisphere-damaged (LHD) and right-hemisphere-damaged (RHD) patients and nonneurological controls. They were instructed to read sentences containing double-stressed target words in the presence of a clause boundary or its absence. Whereas all three groups of subjects were capable of manipulating the acoustic parameters that signal a shift in stress, there were some differences between the performance of the patient groups and that of the normal controls. Further, stress production deficits were more severe in LHD aphasic patients than in RHD patients. LHD speakers exhibited deficits in the control of both temporal and F0 cues. Their F0 disturbance appears to be secondary to a primary deficit in temporal control at the phase or sentence level, as an increased number of continuation rises found for the LHD patients seemed to arise from lengthy pauses within sentences. Findings are highlighted to address the nature of breakdown in speech prosody and the competing views of prosodic lateralization.     

Why Is Cancer Genetic Counseling Underutilized by Women Identified as at Risk for Hereditary Breast Cancer? Patient Perceptions of Barriers Following a Referral Letter

Family history information comprises an important tool in identifying and referring patients at risk for hereditary breast and ovarian cancer (HBOC) to cancer genetic counseling. Despite recommendations and support provided by numerous professional organizations, cancer genetic counseling services are underutilized by atrisk patients. This study aimed to: (1) determine the rate of genetic counseling utilization following a referral letter, (2) characterize factors (barriers and supports) which influenced uptake of services, and (3) identify potential strategies for increasing utilization. This study evaluated the uptake of cancer genetic counseling among 603 screening mammography patients identified as having an increased risk for HBOC based on National Comprehensive Cancer Network (NCCN) guidelines. At risk individuals and their primary care providers were mailed a referral letter recommending genetic counseling. Three focus groups (N = 24) were conducted to identify responses to receiving a letter recommending genetic counseling, barriers to seeking genetic counseling, and facilitating factors to utilizing these services. Participant responses were qualitatively analyzed using thematic and cross case analysis. Within one year, 50/603 (8 %) of the identified at-risk women completed a genetic counseling appointment. Participant-perceived barriers which influenced their decision not to seek genetic counseling included lack of relevance and utility, limited knowledge about genetic counseling, concerns about the genetic counseling process, and concerns about cost and insurance coverage. Participant-perceived facilitating factors which would support a decision to seek genetic counseling included greater awareness and education about genetic counseling services when receiving a referral, and improved follow up and guidance from their provider. Findings from this study support the need for patient and primary care provider education, and improved provider-patient communication to increase uptake of genetic counseling services.     

Optimism and well-being: a prospective multi-method and multi-dimensional examination of optimism as a resilience factor following the occurrence of stressful life events

Optimism has been conceptualised variously as positive expectations (PE) for the future , optimistic attributions , illusion of control , and self-enhancing biases. Relatively little research has examined these multiple dimensions of optimism in relation to psychological and physical health. The current study assessed the multi-dimensional nature of optimism within a prospective vulnerability-stress framework. Initial principal component analyses revealed the following dimensions: PEs, Inferential Style (IS), Sense of Invulnerability (SI), and Overconfidence (O). Prospective follow-up analyses demonstrated that PE was associated with fewer depressive episodes and moderated the effect of stressful life events on depressive symptoms. SI also moderated the effect of life stress on anxiety symptoms. Generally, our findings indicated that optimism is a multifaceted construct and not all forms of optimism have the same effects on well-being. Specifically, our findings indicted that PE may be the most relevant to depression, whereas SI may be the most relevant to anxiety.     

Students' Reactions to Attending 12‐Step Meetings: Implications for Counselor Education

This content analysis of reflective papers examined undergraduate and graduate students' reactions to attending a 12‐step meeting. Qualitative analysis of student comments suggested that meeting attendance had a personal impact and increased understanding of the purpose of 12‐step programs. Implications for counselor educators are discussed.     

Conceptual and Moral Development of Substance Abuse Counselors: Implications for Training

The relationship among substance abuse counselors' education, experience, recovery status, and cognitive development (conceptual complexity and moral reasoning levels) was examined in a simultaneous multiple regression. Significant relationships were found between counselors' level of conceptual complexity and moral reasoning and their education. Implications for counselor training are presented.     

Conformity effects in memory for actions

The goal of this research was to examine whether memories for actions can be affected by information reported by another person. In two studies, pairs of participants performed 48 of a set of 96 actions. In Study 1, both members of the pairs performed the same actions, and in Study 2, they performed different actions. One week later, the members of the pairs were questioned together about whether they had or had not done all 96 actions. What one person reported greatly influenced what the other person reported for both correct and incorrect responses. This influence was maintained when the participants were later tested individually, and the participants described having pictorial memories for doing many of the actions that they had not done but had merely been suggested.     

Millennials and the World of Work: The Impact of Obesity on Health and Productivity

Purpose  

Thirty states now report one in three children between 10–17 years of age are either overweight or obese. This disturbing trend will have lasting implications for our children, specifically those known as the Millennial generation born between 1982 and 1993.