‘Healthy eating’ clinics in primary care: Programme intensity and patients' health beliefs

The primary care setting is seen by many to be at the forefront of the attempt to encourage people to follow healthier diets. Conducted in a single practice, the present study firstly considered the effectiveness of three ‘healthy eating’ clinics for patients found to have elevated cholesterol levels at screening. Through the use of a randomised trial, these patients received either basic dietay information or were invited back more frequently and requested to complete food diaries, half of which were then analysed through a computer program. At one year follow up the three programmes were found to have produced a 6.7% reduction in cholesterol levels. However, no differences were found between the three programmes. The study secondly examined a range of health belieji, based on the health belief model, as predictors of reductions in cholesterol levels. These were generally found to be poor predictors, with only the belief that one's diet is related to the chances of developing a number of major conditions and the perception of bam'ers dealing with confidence predicting these reductions. Finally, the case for incorporating self-efficacy beliefs into the healh belief model is outlined and the need for health counsellors to tailor their messages to the pre-existing beliefi and behaviours of patients is highlighted.     

Parallel distributed processing and neuropsychology: A neural network model of Wisconsin card sorting and verbal fluency

Neural networks can be used as a tool in the explanation of neuropsychological data. Using the Hebbian Learning Rule and other such principles as competition and modifiable interlevel feedback, researchers have successfully modeled a widely used neuropsychological test, the Wisconsin Card Sorting Test. One of these models is reviewed here and extended to a qualitative analysis of how verbal fluency might be modeled, which demonstrates the importance of accounting for the attentional components of both tests. Difficulties remain in programming sequential cognitive processes within a parallel distributed processing (PDP) framework and integrating exceedingly complex neuropsychological tests such as Proverbs. PDP neural network methodology offers neuropsychologists co-validation procedures within narrowly defined areas of reliability and validity.     

The design and use of the Bioethics Consultation Form

The emergence of the ethics consultation as a means to resolve moral crises in clinical medicine has revealed the need for a worksheet that would facilitate intake and analysis. The author developed the Bioethics Consultation Form as an attempt to remedy this need. The form is arranged in an outline format and is a useful asset to ethics committee discussions and record keeping. The first section covers basic intake data concerning the patient's medical and personal information, advance directives, and values, as well as the values of the physician and family. After the intake section is completed with the above data, the ethics consultant then turns to the analysis section. This second section allows for (1) the discussion of conflicting values, (2) the identification of priorities, and (3) the elucidation of ethical norms relevant to the case.The Bioethics Consultation Form was adopted by the Patient Care Advisory committee of the Franklin Square Hospital Center in Baltimore, Maryland in 1986. The methodology in the use of the form will be discussed. Further, the potential spectrum of consultative cases that can be analyzed using the form will be highlighted.     

Developmental sequences in the age of onset of disruptive child behaviors

Retrospective and prospective reports of the onset of disruptive child behaviors were analyzed in a sample of clinic-referred boys. The younger boys (ages 7–9 years), compared with the older boys (ages 10–12 years), showed the highest level of disruptive behavior and, judging from mothers' reports, had the fastest progression of onsets from less serious to more serious problem behaviors. Despite some overlap, developmental sequences in problem behavior within the domains of hyperactivity/inattention, oppositional behavior, and conduct problems were similar across the two age groups. This was also the case for developmental sequences of overt or confrontive problem behaviors and covert or concealing conduct problems. Sequences of the onset of oppositional behavior and conduct problems were validated through prospective data, based on the information from mothers, teachers, and boys themselves. The implications of the findings are discussed for the formulation of developmental pathways of behavior and the analysis of causal factors.     

How,in Our Time,Can We Learn about Spirituality?

A rule of thinking which would absolutely prevent me from acknowledging certain kinds of truth, if those kinds of truth were really there, would be an irrational rule.     

A note on russell's paradox in locally cartesian closed categories

Working in the fragment of Martin-Löfs extensional type theory [12] which has products (but not sums) of dependent types, we consider two additional assumptions: firstly, that there are (strong) equality types; and secondly, that there is a type which is universal in the sense that terms of that type name all types, up to isomorphism. For such a type theory, we give a version of Russell's paradox showing that each type possesses a closed term and (hence) that all terms of each type are provably equal. We consider the kind of category theoretic structure which corresponds to this kind of type theory and obtain a categorical version of the paradox. A special case of this result is the degeneracy of a locally cartesian closed category with a morphism which is generic in the sense that every other morphism in the category can be obtained from it via pullback.The financial support of the Royal Society in London is gratefully acknowledged.