Family therapy in a community mother and toddler project

A home centred family therapy approach is described based on the McMaster model. This approach was applied in a controlled trial of three forms of intervention for mother and toddler problems. In this paper the experience of applying the approach is reported.     

Effects of neonatal forebrain noradrenaline depletion on recovery from brain damage: performance on a spatial navigation task as a function of age of surgery and postsurgical housing

The experiments examined the contributions of forebrain noradrenaline and environmental enrichment to recovery of place navigation ability in rats after hemidecortication in infancy or adulthood. Noradrenaline depletion did not affect recovery from neonatal hemidecortication, although the early hemidecortications did allow sparing of function relative to adult operates. Noradrenaline depletion also failed to attenuate the positive effects of enriched housing on otherwise normal rats. Noradrenaline depletion did retard recovery of adult hemidecorticate rats housed in standard laboratory cages, but it did not retard recovery of adult hemidecorticate rats housed in enriched environments. The results suggest that noradrenaline is importantly involved in enhancing recovery from brain damage when other sources of compensation (e.g., neonatal injury, enriched environment) are absent.     

Retrospective coding in pigeons' delayed matching-to-sample

In this study we examined how coding processes in pigeons' delayed matching-to-sample were affected by the stimuli to be remembered. In Experiment 1, two groups of pigeons initially learned 0-delay matching-to-sample with identical comparison stimuli (vertical and horizontal lines) but with different sample stimuli (red and green hues or vertical and horizontal lines). Longer delays were then introduced between sample offset and comparison onset to assess whether pigeons were prospectively coding the same events (viz., the correct line comparisons) or retrospectively coding different events (viz., their respective sample stimuli). The hue-sample group matched more accurately and showed a slower rate of forgetting than the line-sample group. In Experiment 2, pigeons were trained with either hues or lines as both sample and comparison stimuli, or with hue samples and line comparisons or vice versa. Subsequent delay tests revealed that the hue-sample groups remembered more accurately and generally showed slower rates of forgetting than the line-sample groups. Comparison dimension had little or no effect on performance. Together, these data suggest that pigeons retrospectively code the samples in delayed matching-to-sample.     

Categorical shape and color coding by pigeons

Categorical coding is the tendency to respond similarly to discriminated stimuli. Past research indicates that pigeons can categorize colors according to at least three spectral regions. Two present experiments assessed the categorical coding of shapes and the existence of a higher order color category (all colors). Pigeons were trained on two independent tasks (matching-to-sample, and oddity-from-sample). One task involved red and a plus sign, the other a circle and green. On test trials one of the two comparison stimuli from one task was replaced by one of the stimuli from the other task. Differential performance based on which of the two stimuli from the other task was introduced suggested categorical coding rules. In Experiment 1 evidence for the categorical coding of sample shapes was found. Categorical color coding was also found; however, it was the comparison stimuli rather than the samples that were categorically coded. Experiment 2 replicated the categorical shape sample effect and ruled out the possibility that the particular colors used were responsible for the categorical coding of comparison stimuli. Overall, the results indicate that pigeons can develop categorical rules involving shapes and colors and that the color categories can be hierarchical.     

Quality-of-life measures: hospital interview versus home questionnaire

Measures adapted from social survey research were used to assess the quality of life of 33 end-stage renal disease (ESRD) patients in a 2-week test-retest design that varied both location and format of administration (hospital interview vs. home self-administered questionnaire). The measures were found to have substantial consistency over time, location, and format. These results indicate that quality of life is a stable construct and support the usefulness of questionnaire quality-of-life measures for evaluating medical interventions.     

Health as a value: methodological and theoretical considerations

The concept of value placed on health is very important in several different theoretical approaches to the study of health behavior. In practice, however, health value is generally assumed to be universally high rather than being directly measured. If this assumption is incorrect, then theories that include health value have rarely been adequately tested. This paper presents a short 4-item Likert scale designed to measure the value placed on health. Norms from the utilization of this scale in five different samples are presented. Health value is found to increase with age among girls, but the increase apparently stops by late adolescence, before full adult levels of health value are achieved. Middle-aged women place a higher value on health than do middle-aged men, although no comparable sex difference appears in a sample of undergraduates. Consistent with theoretical predictions, both health locus of control beliefs and beliefs in the efficacy of certain preventive health behaviors correlate more highly with the performance of those same behaviors 5 to 9 months later among respondents who place a high value of health relative to those who do not value health so highly. However, this interaction is found only when it can be safely assumed that health is the primary value underlying the behavior. The importance of considering a variety of values in addition to health as possible motivators of preventive health behavior is stressed.     

Attitudes toward posthumous organ donation and commitment to donate

The medical need for human organs suitable for use as transplants far exceed the supply, and is growing. More favorable attitudes about organ donation would increase people's willingness to sign posthumous donation pledges. But effective educational programs require information about the public's present views. Verbal attitude scales were constructed and administered to 110 adults, resulting in reliable measurement of two independent dimensions, prodonation and antidonation (r = .003). Cluster analysis of the instrument revealed that the positive dimension involves belief in the humanitarian benefits of organ donation and feelings of pride experienced by the donor. The negative dimension reflects fears of body mutilation and of receiving inadequate medical treatment when one's life is at risk. Pro and anti scores in combination predicted willingness to sign a donor card. A 2 X 2 analysis of variance (High-Low Positive X High-Low Negative) revealed significant main effects for both positive and negative attitude. Also, a significant interaction effect was obtained. Those subjects who had both strong positive attitudes and weak negative attitudes were especially willing to sign donor cards. Suggestions for designing educational campaigns to promote organ donation are offered.     

A comparison of three predictors of an individual's memory performance: the individual's feeling of knowing versus the normative feeling of knowing versus base-rate item difficulty

Distinctions are drawn between different predictors of an individual's memory performance, with emphasis on the notion of privileged access to idiosyncratic knowledge. Research is reported in which undergraduates attempted to recall the answers to general-information questions, then made feeling-of-knowing judgments on nonrecalled items, and subsequently had a criterion test (relearning, perceptual identification, or one of two versions of recognition). For predicting an individual's criterion performance, the individual's own feeling-of-knowing predictions were intermediate between two kinds of normative predictions: The individual's feeling-of-knowing predictions were more accurate than predictions derived from normative feeling-of-knowing ratings but were less accurate than predictions derived from base-rate item difficulty (normative probabilities of correct recall). Subsidiary analyses showed that factors other than unreliability are responsible for the partial inaccuracy of the individual's feeling of knowing. Ramifications are discussed for possible ways to improve the accuracy of an individual's feeling-of-knowing predictions.     

Cognitive, motivational, social, and environmental influences on children's food choices

This study tested the applicability of a cognitive-motivational model of health behavior to children's food choices. A sample of 107 elementary schoolchildren provided ratings of 15 foods in terms of possible choice criteria (e.g., how tasty or healthful specific foods were) and social or environmental influences (e.g., whether foods were eaten by friends or were easy to get). Several measures of food consumption were taken, and cognitive-developmental level was assessed. Within-person correlations were calculated between food choices and each choice criterion and social/environmental factor. These "correlational indices" of influences on food choice subsequently were used to identify five distinct subgroups in the sample. Children at the operational level of cognitive development tended to be in one of three groups characterized by health orientation in food choice, taste orientation, or multiple-motive orientation. Dietary quality was poorest in the taste-oriented group. Children at the preoperational level tended to have one of two undifferentiated patterns of values across the correlational indices. Results provide evidence of: the viability of cognitive-motivational models to explain children's food choices, the promise of within-person research methodology, and the potential for enhanced health behavior-change programs by use of population segmentation and tailored interventions.     

Relationship of physicians' nonverbal communication skill to patient satisfaction, appointment noncompliance, and physician workload

A field study of 28 residents in family practice was conducted. Physicians' self-reports of empathy, self-monitoring ability, and affective communication skill as well as their objectively measured nonverbal communication skills were examined as predictors of patient satisfaction, appointment noncompliance, and physician workload (schedule density). Physicians completed the Hogan Empathy Scale, Snyder Self-Monitoring Scale, Affective Communication Test, short form of the Profile of Nonverbal Sensitivity, and a nonverbal encoding task. Patient satisfaction with communication, affective care, and technical care was assessed using a 25-item, visit-specific satisfaction scale. Appointment records were used to determine the number of patients seen by each physician and the compliance of patients with scheduled appointments. Results indicated that the three self-report measures were unrelated to the measures of patient noncompliance and patient satisfaction, but self-reported affective communication ability was significantly correlated with physician workload. Objectively measured physician sensitivity to audio communication predicted patient compliance: More sensitive physicians experienced fewer unrescheduled appointment cancellations. Nonverbal encoding skill was significantly related to patient satisfaction with affective care and to physician workload.