Status of perfusion scintigraphy in the diagnostic strategy in cerebrovascular disorders and space-occupying lesions

The results of an evaluation of the perfusion scintigraphy findings of 350 hospitalised neurological patients and 55 more strictly selected neurosurgical patients with cerebrovascular complaints, revealed an accuraty of 83%, a sensitivity of 89%, and a specificity of 83%. The selection of the patients had no influence on the results as a whole. Compared with contrast-medium angiography, incorrect diagnosis must be expected in 17% of the cases. This includes erroneous negative findings in 10% of the cases. Grounds for misinterpretations are suggested, and the biological and methodological limitations of the method are set forth.     

Community responses following suicide, homicide, and other deaths: the perspective of potential comforters

To determine whether actual responses of potential comforters in the community differ according to cause of death, 83 college students participated in a structured, individual interview. They were asked demographic questions about themselves, the bereaved, and the deceased, and then about various aspects of how they, and others in the community, responded to the death. Students were grouped by their reports of the cause of death (suicide, homicide, accident, natural anticipated death, or natural unanticipated death). When the death was by suicide or homicide, others were perceived as relatively less supportive of the bereaved person. When the death was by suicide, respondents themselves tended more to blame the bereaved person. When the death was by homicide, the bereaved person was perceived as reacting relatively worse. Potential comforters were relatively more shocked when the death was by homicide or accident.     

Discovering what it all means

This article deals with appropriate communication and interpersonal skills that nurses may use in order to support patients who are experiencing self-concept changes related to their health problems. Three areas of patient need related to self-concept are explored. The stages of adaptation to loss and the crucial task of grief work are reviewed, and nursing interventions designed to strengthen the self-concept and support patients as they adapt to loss are suggested. Sensitive communication, although a low-visibility nursing skill, is cited as critical in assisting the patient to achieve an optimum level of wellness.     

Physicians and clergy in dialogue

The goals and ends of contemporary medicine are often unclear. An explicit inquiry into the religious dimensions of healing offers an important perspective from which to evaluate the potential capabilities of the medical profession. This paper describes a course in which medical students joined divinity students to explore areas of mutual intellectual, professional, and personal interest. Students and faculty examined in depth three broad areas in which medicine and religion share common ground: concepts of health and illness from the religious perspective, approaches to the understanding of suffering and meaning, and the shared professional stresses of physician and clergy.This paper comes from the Department of Medicine, Beth Israel Hospital, and the Division on Aging and the Program for the Analysis of Clinical Strategies, Harvard Medical School, and the West Roxbury-Brockton Veterans Administration Geriatric Research, Education and Clinical Center, Boston.     

Computer-generated psychological reports: a look at the modern psychometric machine

The proliferation of computer-generated psychological reports prompts an examination of the presuppositions of such reports and what they offer in the way of understanding individual clients. This topic is approached primarily through a review of some basics of psychological testing and psychological assessment. Major differences are noted between these two approaches to evaluating clients: They are different processes, and they yield different products. Assessment is a complex set of activities that seeks solutions to specific problems, whereas testing fits a straightforward actuarial paradigm. Testing is readily adapted to an automated data processing system, whereas the complex of assessment procedures cannot be so managed. Serious questions about the validity of computer reports are raised, however, and ethical concerns are expressed over the use of these reports by persons without adequate psychological training to understand them correctly. Limited uses for computer reports are suggested along with the need for further studies of validity and ethics.     

Delayed temporal discrimination in pigeons: A comparison of two procedures

A within-subjects comparison was made of pigeons' performance on two temporal discrimination procedures that were signaled by differently colored keylight samples. During stimulus trials, a peck on the key displaying a slanted line was reinforced following short keylight samples, and a peck on the key displaying a horizontal line was reinforced following long keylight samples, regardless of the location of the stimuli on those two choice keys. During position trials, a peck on the left key was reinforced following short keylight samples and a peck on the right key was reinforced following long keylight samples, regardless of which line stimulus appeared on the correct key. Thus, on stimulus trials, the correct choice key could not be discriminated prior to the presentation of the test stimuli, whereas on position trials, the correct choice key could be discriminated during the presentation of the sample stimulus. During Phase 1, with a 0-s delay between sample and choice stimuli, discrimination learning was faster on position trials than on stimulus trials for all 4 birds. During Phase 2, 0-, 0.5-, and 1.0-s delays produced differential loss of stimulus control under the two tasks for 2 birds. Response patterns during the delay intervals provided some evidence for differential mediation of the two delayed discriminations. These between-task differences suggest that the same processes may not mediate performance in each.     

Leadership skills and helpful factors in self-help groups

The effects of training on leadership skills and group processes in cancer and anorexic self-help groups are investigated. Three components of the study are reported. Firstly, an observational case-study of each type, of group was conducted to investigate the nature of the leadership input. Secondly, a Self-Help Questionnaire based on Lieberman's classification of leadership skills was administered to members of eight self-help groups to compare the experiences of groups with trained and untrained leaders. Thirdly, group members completed a Helpful Factors Questionnaire based on Yalom's analysis of group processes. The observational case-study revealed significant differences between the trained and untrained leaders in that, unlike the trained leader, the untrained leader clearly dominated the group. Results from the Self-Help Questionnaire showed that trained leaders scored higher on Caring and Emotional Stimulation but lower on Attribution of Meaning. Member satisfaction, however, was similar in the two types of group. Results from the Helpful Factors Questionnaire showed that most of the helpful factors were seen similarly by the two types of group, though differences were found concerning the relative rankings of both Guidance and Altruism. It is concluded that some degree of training of group leaders could be usefully incorporated into the self-help movement.     

Relative effectiveness of three stimulus variables for locating a moving sound source

A study is reported in which it is shown that observers can use at least three types of acoustic variables that indicate reliably when a moving sound source is passing: interaural temporal differences, the Doppler effect, and amplitude change. Each of these variables was presented in isolation and each was successful in indicating when a (stimulated) moving sound source passed an observer. These three variables were put into competition (with each indicating that closest passage occurred at a different time) in an effort to determine their relative importance. It was found that amplitude change dominated interaural temporal differences which, in turn, dominated the Doppler effect stimulus variable. The results are discussed in terms of two interpretations. First, it is possible that subjects based their judgements on the potential discriminability of each stimulus variable. However, because the stimuli used involved easily discriminable changes, subjects may instead have based their judgements on the independence of a stimulus variable from different environmental situation conditions. The dominance ordering obtained supports the second interpretation.     

The development of sex differences in young children's activities at home: The effect of the social context

Randomly scheduled spot observations of 83 zero to six-year-old American middle-class children were used to investigate factors affecting the development of sex differences in young children's activities in and near their home. Sex and age differences in children's typical play and nonplay activities and in the people with whom they did activities were examined. The results showed that there were fewer sex differences in children's activities, activity partners, and general social settings than expected. Girls spent more time engaged in housework and school-related activities than boys, while boys spent more time in social gross motor play with other children and in self-care activities than girls. Children spent a surprisingly large amount of their time with members of their immediate family — particularly their mother and one other sibling. Boys and girls did not differ, however, in the time they were in settings or doing activities with their father, with their mother, or with same-or mixed-sex child groups.This research was supported by an award to the author from the Wisconsin Alumnae Research Foundation at the University of Wisconsin — Madison. The author would also like to acknowledge the research and editorial assistance of Daniel J. Walsh. In addition, Aletha Huston, Beatrice B. Whiting, and Gary G. Price provided valuable advice on this and earlier versions of this paper.