Clinical pragmatism: a method of moral problem solving

This paper presents a method of moral problem solving in clinical practice that is inspired by the philosophy of John Dewey. This method, called "clinical pragmatism," integrates clinical and ethical decision making. Clinical pragmatism focuses on the interpersonal processes of assessment and consensus formation as well as the ethical analysis of relevant moral considerations. The steps in this method are delineated and then illustrated through a detailed case study. The implications of clinical pragmatism for the use of principles in moral problem solving are discussed.     

The specific action of different personality risk factors on cancer of the breast, cervix, corpus uteri and other types of cancer: A prospective investigation

We report the results of a prospective study of a random sample of 1353 elderly but healthy men and women who were followed up for a period of 10 yr, when mortality and cause of death were ascertained. Overall results have been reported elsewhere for mortality from cancer, coronary heart disease and other causes; here we are concerned with the personality factors predicting breast cancer, cervical cancer, cancer of the corpus uteri specifically, as well as other types of cancer in women. Ten specific hypotheses were tested, using specially constructed questionnaires for the purpose, and for most of these statistically significant support was obtained. The results justify belief that specific types of cancer may be related to specific stress/personality factors.     

Sexuality education and young people's sexual behavior: a review of studies

Sexuality education for children and young adults is one of the most heavily debated issues facing policy-makers, national AIDS program planners, and educators, provoking arguments over how explicit education materials should be, how much of it there should be, how often it should be given, and at what age instruction should commence. In this context, the World Health Organization's Global Program on AIDS' Office of Intervention Development and Support commissioned a comprehensive literature review to assess the effects of HIV/AIDS and sexuality education upon young people's sexual behavior. 52 reports culled from a search of 12 literature databases were reviewed. The main purpose of the review is to inform policy-makers, program planners, and educators about the impact of HIV and/or sexuality education upon the sexual behavior of youth as described in the published literature. Of 47 studies which evaluated interventions, 25 reported that HIV/AIDS and sexuality education neither increased nor decreased sexual activity and attendant rates of pregnancy and sexually transmitted diseases (STDs). 17 reported that HIV and/or sexuality education delayed the onset of sexual activity, reduced the number of sex partners, or reduced unplanned pregnancy and STD rates Only 3 studies found increases in sexual behavior associated with sexuality education. Inadequacies in study design, analytic techniques, outcome indicators, and the reporting of statistics are discussed.     

TIME COURSE OF ACTIVATING BRAIN AREAS IN GENERATING VERBAL ASSOCIATIONS

Abstract— Generating a use far a visual word in comparison with reading the word aloud activates frontal attention areas first (170 MS), a left lateral frontal area next (250 ms), and then a left temporoparietal (Wernicke's) area (650 ms). A brief period of practice reduces these activations. If subjects are asked to respond to a word from the same practiced list by giving a novel use, the original activations reappear and are joined by activity similar in location and time to Wernicke's activation but in the right hemisphere. These findings demonstrate the time course of activations of neuroanatomical areas in word processing and indicate a role for the right hemisphere when semantic processing is more difficult, such as in generating a less frequent association in the presence of a highly practiced one.     

Changes in Newcomers' Person–Climate Fit following the First Stage of Socialization

The development of attitudes and activities of newcomers in the 18 months following the first period of socialization was investigated. At two points in time, persons' preferences for seven work climates were compared with perceived climate. Changes in person-climate fit were assessed, using a squared difference index, after alternative fit-indices were tested with hierarchical regression analysis. Person-climate fit and work attitudes at T1 (eight to ten months after entry) were examined by comparing three groups of respondents who did not change jobs, changed jobs within the organization or changed organizations. Results showed no alpha, beta or gamma changes for the total group of 108 respondents. Alpha changes were only found for respondents who changed jobs. They showed higher ratings for job satisfaction at T2. Finally, work attitudes at T1 were related to turnover. Organizational changers showed higher turnover intentions and higher discrepancies between preferred and perceived risk orientation and work pressure at T1.     

EMERGENCE OF REINFORCER PREFERENCE AS A FUNCTION OF SCHEDULE REQUIREMENTS AND STIMULUS SIMILARITY

Tustin (1994) recently observed that an individual's preference for one of two concurrently available reinforcers under low schedule requirements (concurrent fixed-ratio [FR] 1) switched to the other reinforcer when the schedule requirements were high (concurrent FR 10). We extended this line of research by examining preference for similar and dissimilar reinforcers (i.e., those affecting the same sensory modality and those affecting different sensory modalities). Two individuals with developmental disabilities were exposed to an arrangement in which pressing two different panels produced two different reinforcers according to progressively increasing, concurrent-ratio schedules. When two dissimilar stimuli were concurrently available (food and a leisure item), no clear preference for one item over the other was observed, regardless of the FR schedules in effect (FR 1, 2, 5, 10, and 20). By contrast, when two similar stimuli were concurrently available (two food items), a clear preference for one item emerged as the schedule requirements were increased from FR 1 to FR 5 or FR 10. These results are discussed in terms of implications for conducting preference assessments and for selecting reinforcers to be used under training conditions in which response requirements are relatively high or effortful.     

HYPOTHESIS-BASED INTERVENTIONS FOR TANTRUM BEHAVIORS OF PERSONS WITH DEVELOPMENTAL DISABILITIES IN SCHOOL SETTINGS

We conducted a functional assessment of problem behaviors of 2 students with developmental disabilities in their classroom environments. Results of the assessments showed that although there were more tantrums in demand than in no-demand conditions, the function of the behavior was to gain attention (positive reinforcement) rather than to avoid or escape demands (negative reinforcement); demand conditions apparently served a discriminative function for the availability of attention. Therefore, intervention was based on the positive reinforcement hypothesis, resulting in a substantial reduction of tantrums for both subjects.     

The effects of temporal-precision and time-minimization constraints on the spatial and temporal accuracy of aimed hand movements

Discrete aimed hand movements, made by subjects given temporal-accuracy and time-minimization task instructions, were compared. Movements in the temporal-accuracy task were made to a point target with a goal movement time of 400 ms. A circular target then was manufactured that incorporated the measured spatial errors from the temporal-accuracy task, and subjects attempted to contact the target with a minimum movement time and without missing the circular target (time-minimization task instructions). This procedure resulted in equal movement amplitude and approximately equal spatial accuracy for the two task instructions. Movements under the time-minimization instructions were completed rapidly (M = 307 ms) without target misses, and tended to be made up of two submovements. In contrast, movements under temporal-accuracy instructions were made more slowly (M = 397 ms), matching the goal movement time, and were typically characterized by a single submovement. These data support the hypothesis that movement times, at a fixed movement amplitude versus target width ratio, decrease as the number of submovements increases, and that movements produced under temporal-accuracy and time-minimization have different control characteristics. These control differences are related to the linear and logarithmic speed-accuracy relations observed for temporal-accuracy and time-minimization tasks, respectively.     

The role of neuroimaging in the discovery of processing stages a review

In this contribution we show how neuroimaging methods can augment behavioural methods to discover processing stages. Event Related Brain Potentials (ERPs), Brain Electrical Source Analysis (BESA) and regional changes in cerebral blood flow (rCBF) do not necessarily require behavioural responses. With the aid of rCBF we are able to discover several cortical and subcortical brain systems (processors) active in selective attention and memory search tasks. BESA describes cortical activity with high temporal resolution in terms of a limited number of neural generators within these brain systems. The combination of behavioural methods and neuroimaging provides a picture of the functional architecture of the brain. The review is organized around three processors: the Visual, Cognitive and Manual Motor Processors.     

An evaluation of differential prediction of WIAT achievement scores from WISC-III FSIQ across ethnic and gender groups

This study examines differential prediction of WIAT achievement scores based on WISC-III FSIQ in white as compared with African American and Hispanic children, and in females as compared with males. A procedure which allows simultaneous comparisons of slopes and intercepts across groups is employed. The results are consistent with previous research findings in supporting the general absence of bias in predicting achievement from IQ.