Just health care (II): Is equality too much?

In a previous essay I criticized Engelhardt's libertarian conception of justice, which grounds the view that society's obligation to assure access to adequate health care for all is a matter of beneficence [1]. Beneficence fails to capture the moral stringency associated with many claims for access to health care. In the present paper I argue that these claims are really matters of justice proper, where justice is conceived along moderate egalitarian lines, such as those suggested by Rawls and Daniels, rather than strong egalitarian lines. Further, given the empirical complexity associated with the distribution of contemporary health care, I argue that what we really need to address the relevant policy issues adequately is a theory of health care justice, as opposed to an all-purpose conception of justice. Daniels has made an important start toward that goal, though there are some large policy areas which I discuss that his account of health care justice does not really speak to. Finally, practical matters of health care justice really need to be addressed in a ‘non-ideal’ mode, a framework in which philosophers have done little.     

NEWSART: Negative binomial weighted spectral analysis in real time

In this paper, digital filters are described for concurrent adaptive estimation of the spectral powers at several target frequencies. Least-squares estimation is used, with a tapered weight function that discounts time-series data according to age. Frequency selectivity and reliability of spectral estimates are controlled by different parameters. The spectral windows are closely approximated by Student’st distribution, which is useful in the planning of experiments.     

A program for constructing SVT tests: An alternative way of assessing text comprehension

The sentence verification technique (SVT), developed by Royer, Hastings, and Hook (1979), provides developmental and educational researchers with an alternative way of assessing text comprehension based on all of the information contained in a passage. Students must decide if test sentences have the same meaning as sentences that appeared in an original passage. The program described here automates the more laborious aspects of constructing SVT tests. The user must create a passage using a word processor. The program will prompt the user for information as needed. Finally, printable text files (SVT test and answer key) are generated. The program is written in BASIC for IBM and IBM-compatible computers.     

Abuse of persons with mental retardation: A literature review

The literature reports a number of reasons why abuse of people with mental retardation occurs. These causes of abusive behavior can be divided into three categories: organizational variables, staff characteristics, and client characteristics. The author examines each of the variables and presents recommendations for reducing their contributions to abusive behavior.     

Teaching dancercise to persons who are mentally handicapped: Programming transfer of stimulus control to a community setting

This study demonstrated procedures to promote the acquisition and transfer of stimulus control of an age-appropriate exercise skill. Three young adults diagnosed as mentally handicapped in a residential setting were taught a commercial dancercise routine during individual training sessions using a package of instructional procedures. A combination of a multiple baseline across subjects and a multiple baseline across response groups design showed that skill acquisition occurred only after each subject received training, and that performance did not generalize across exercise response groups. Training progressively incorporated more participants, new teachers, and new settings. Ultimately, subjects performed in a community dancercise class attended by 100 nonhandicapped persons.     

Discrimination of facial expressions of emotion by depressed subjects

A frequent complaint of depressed people concerns their poor interpersonal relationships. Yet, although nonverbal cues are considered of primary importance in interpersonal communication, the major theories of depression focus little attention on nonverbal social perception. The present study investigated the ability of depressed, disturbed control, and normal American adults to make rapid discriminations of facial emotion. We predicted and found that depressed subjects were slower than normal subjects in facial emotion discrimination but were not slower in word category discrimination. These findings suggest that current theories of depression may need to address difficulties with nonverbal information processing. There were also no significant differences between depressed and disturbed control subjects, suggesting that the unique social-behavioral consequences of depression have yet to be identified.     

One-session treatment for specific phobias

A rapid and effective treatment for specific phobias, in which the treatment is done in one single session, is described in detail. The treatment method consists of a combination of exposure in vivo and modeling. The short- and long-term outcome for a consecutive series of 20 patients are reported. Mean treatment time was 2.1 h and at follow-up after an average of 4 yr 90% were much improved or completely recovered.     

A controlled comparative investigation of psychological treatments for chronic sleep-onset insomnia

A sample of physician-referred chronic insomniacs was randomly allocated to either progressive relaxation, stimulus control, paradoxical intention, placebo or no treatment conditions. Treatment process and outcome were investigated in terms of mean and standard deviation (night to night variability) measures of sleep pattern and sleep quality. Only active treatments were associated with significant improvement, but the nature of treatment gains varied. In particular, stimulus control improved sleep pattern, whereas relaxation affected perception of sleep quality. All improvements were maintained at 17 month follow-up. Results are discussed with reference to previous research and guidelines are given for clinical practice.