Accountability and team care

Although we normally have no difficulty with holding individuals accountable for the effects of their actions, we are still confused about holding a health care team accountable. I argue that we can hold teams accountable in the same way that we hold individuals accountable. In constructing this argument, I first examine the nature of a “team,” then look at the consequences of team decision and action, in particular, the problem of synergistic decisionmaking. Finally I relate this philosophical discussion to patient care decisions by teams.     

Comparing lesbian and heterosexual couples on the circumplex model: an initial investigation

This study extends the research on the Circumplex Model to a population of lesbian couples. Instruments consisted of a demographic questionnaire, FACES III, and the Family Satisfaction Scale. Lesbian couples reported significantly higher levels of cohesion, adaptability, and satisfaction than did heterosexual couples. Exceptionally high levels of cohesion and adaptability may help lesbian couples function more successfully in a predominantly heterosexual world. Further, women's socialization may predispose female couples to form more cohesive and adaptable relationships than heterosexual couples. This article also emphasizes the cultural relativity of family norms for studies of lesbian and all minority population couples.     

Response restriction and substitution with autistic children.

Few studies to date have examined time reallocation in naturalistic, multiresponse human repertoires when one or more responses are restricted. For this experiment, free-operant baseline levels of six responses were measured for four autistic children. The high-probability responses were made unavailable, one at a time, such that subjects had access to five, four, three, and two responses in successive restriction conditions. A return to the six-response free-operant baseline condition completed the experiment. Results were compared to predictions made by four time-reallocation models. These results were described accurately only by the selective substitution model. Further analyses examined alternative explanations for the individual reallocation patterns obtained. An expanded selective substitution definition is proposed that may characterize orderly patterns observed in multiresponse repertoires under restriction conditions more accurately than the other existing models.     

Information on response requirements compared with information on food density as a reinforcer of observing in pigeons

On a variable-interval schedule, pecking the key to the pigeon's right (observing response) produced red or green displays relating to the delivery of grain and its dependence on pecking the key to the left (food key). During various blocks of sessions, mixed (no stimulus change) schedules including the following pairs of components were temporarily converted by the observing response to their corresponding multiple (correlated stimuli) schedules: variable-interval 60-s, extinction; variable-interval 60-s, variable-time (response-independent) 60-s; extinction, variable-time 60-s. Differences in food delivery maintained substantial rates of responding on the observing key, without regard to pecking requirements on the food key. Although stimuli correlated with differences in the response requirement on the food key maintained higher observing rates than those maintained by uncorrelated stimuli, they were much lower than those based on food. The value of predictive stimuli as reinforcers is determined by the value of the events predicted. In particular, the cost of pecking appears to be low, and this may place limitations on the applicability of energy-based and economic models of behavior.     

Distance perception as a function of photographic area of view

Distance perception of depicted objects was examined as a function of photographic area of view. Subjects viewed slides of natural outdoor scenes and directly estimated the distances to specified objects. Area of view was manipulated by means of photographing each scene with lenses of five different focal lengths: 135, 80, 48, 28, and 17 mm. Distance perception along the pictorial depth plane was systematically transformed through changing the photographic area of view: the shorter the focal length of the camera lens, the wider the area of view, and the greater the perceived distance. Linear functions for each subject's distance judgments revealed a very high goodness of fit. Both the y-intercepts and the slopes increased as focal length decreased. The increasing y-intercepts suggest that viewers place themselves farther away from the depicted scene as focal length decreases, compensating for the advancing proximal edge. The increasing slopes suggest that distance information throughout the pictorial depth plane appears to change with focal length. The subjects also made direct judgments of foreground truncation, revealing that foreground truncation decreased as focal length decreased, but that this decrease did not account for the considerable expansion in distance perception.     

NONVOCAL LANGUAGE ACQUISITION IN ADOLESCENTS WITH SEVERE PHYSICAL DISABILITIES: BLISSYMBOL VERSUS ICONIC STIMULUS FORMATS

This study compared training in two language systems for three severely handicapped, nonvocal adolescents: the Bliss symbol system and an iconic picture system. Following baseline, training and review trials were implemented using an alternating treatments design. Daily probes were conducted to assess maintenance, stimulus generalization, and response generalization, and data were collected on spontaneous usage of either language system throughout the school day. Results showed that students required approximately four times as many trials to acquire Bliss symbols as iconic pictures, and that students maintained a higher percentage of iconic pictures. Stimulus generalization occurred in both language systems, while the number of correct responses during responses generalization probes was much greater for the iconic system. Finally, students almost always showed more iconic responses than Bliss responses in daily spontaneous usage. These results suggest that an iconic system might be more readily acquired, maintained, and generalized to daily situations. Implications of these findings for the newly verbal person were discussed.