Risk taking from the participant's perspective: the case of driving and accident risk.

Although perceived health risk plays a prominent role in theories of health behavior, its empirical role in risk taking is less clear. In Study 1 (N = 129), 2 measures of drivers' risk-taking behavior were found to be unrelated to self-estimates of accident concern but to be related to self-ratings of driving skill and the perceived thrill of driving. In Study 2 (N = 405), out of a wide range of potential influences, accident concern had the weakest relationship with risk taking. The authors concluded that although health risk is a key feature in many theories of health behavior and a central focus for researchers and policy makers, it may not be such a prominent factor for those actually taking the risk.     

Identifying subgroups that succeed or fail with three levels of physical activity intervention: the Activity Counseling Trial.

The authors used recursive partitioning methods to identify combinations of baseline characteristics that predict 2-year physical activity success in each of 3 physical activity interventions delivered in the multisite Activity Counseling Trial. The sample consisted of 874 initially sedentary primary care patients, ages 35-75 years, who were at risk for cardiovascular disease. Predictors of 2-year success were specific to each intervention and represented a range of domains, including physiological, demographic, psychosocial, health-related, and environmental variables. The results indicate how specific patient subgroups (e.g., obese, unfit individuals; high-income individuals in stable health) may respond differently to varying levels and amounts of professional assistance and support. The methods used provide a practical first step toward identifying clinically meaningful patient subgroups for further systematic investigation.     

Staying Together: A Bidirectional Delay–Coupled Approach to Joint Action

To understand how individuals adapt to and anticipate each other in joint tasks, we employ a bidirectional delay–coupled dynamical system that allows for mutual adaptation and anticipation. In delay–coupled systems, anticipation is achieved when one system compares its own time‐delayed behavior, which implicitly includes past information about the other system’s behavior, with the other system’s instantaneous behavior. Applied to joint music performance, the model allows each system to adapt its behavior to the dynamics of the other. Model predictions of asynchrony between two simultaneously produced musical voices were compared with duet pianists’ behavior; each partner performed one voice while auditory feedback perturbations occurred at unpredictable times during live performance. As the model predicted, when auditory feedback from one musical voice was removed, the asynchrony changed: The pianist’s voice that was removed anticipated (preceded) the actions of their partner. When the auditory feedback returned and both musicians could hear each other, they rapidly returned to baseline levels of asynchrony. To understand how the pianists anticipated each other, their performances were fitted by the model to examine change in model parameters (coupling strength, time‐delay). When auditory feedback for one or both voices was removed, the fits showed the expected decrease in coupling strength and time‐delay between the systems. When feedback about the voice(s) returned, the coupling strength and time‐delay returned to baseline. These findings support the idea that when people perform actions together, they do so as a coupled bidirectional anticipatory system.     

On Making and Keeping Promises

Do the conditions under which promises are made determine whether they ought to be kept? Philosophers have placed a number of conditions on promising which, they hold, must be met in order to make promise-keeping obligatory. In so doing, they have distinguished valid promises from invalid promises and justified promises from promises that are not justified. Considering such conditions, one by one, we argue that they are mistaken. In the first place, the conditions they lay down are not necessary for either valid or justified promise-making. In the second place, promises need not meet such conditions in order to create moral obligations. In general, such analyses of promising fail because they suffer from a confusion between promise-making and promise-keeping. Philosophers have wrongly supposed that obligations to keep promises are dependent upon, or derivable from, the quality of the promises themselves, at the time they are made, instead of focusing on conditions that must be satisfied at the time when promises are supposed to be kept. It is not the quality of a promise that determines an obligation to keep it but the rightness or wrongness of performing the promised act.     

Evidence for clinical smoking cessation for adolescents.

OBJECTIVE: This report reviews the evidence that informs the role of health and mental health care providers in addressing youth smoking cessation. DESIGN: Qualitative literature review. RESULTS: Physicians do not consistently screen adolescents for tobacco use and fail to provide recommended cessation advice. Challenges to addressing smoking cessation include the need for procedures to ensure confidentiality and the existence of competing demands to provide other services. Few published studies have specifically addressed the effectiveness of clinical interventions. Interventions that require return visits or follow-up phone contacts are technically difficult to implement in this population. Successful interventions may require resources not available in nonresearch settings. Most studies have used brief clinical intervention as a control condition, making it impossible to evaluate its effectiveness. CONCLUSION: There is little evidence that supports current clinical smoking cessation guidelines for adolescents. More research is needed to develop inexpensive, efficient clinical interventions that can provide youths access to smoking cessation help. Future challenges include reorganizing clinical systems to offer greater counseling by support staff or in electronic formats and to provide effective booster messages and follow-up care in a population that is difficult to track.