Effects of Social Demand on Reports of Self-Monitored Blood Glucose in Adolescents with Type 1 Diabetes Mellitus

The purpose of this study was to test the hypothesis that social demand could substantially affect reports of self-monitored blood glucose (BG) in adolescents with insulin-dependent diabetes mellitus. Of 34 patients initially enrolled in the study, 10 were excluded because they did not bring any BG records with them to an outpatient clinic appointment. The remaining 24 patients were randomly assigned to either a low or high social demand condition that provided instructions for monitoring of BG for the week following the appointment. The subjects' BG records were quantified to provide frequency of measurement and mean reported BG for the week prior to and after the clinic visit. Five subjects did not return their BG records for the week following the intervention. The analyses were therefore based on the 19 subjects from whom complete records were obtained. The 12 subjects in the low social demand group and 7 subjects in the high social demand group were equivalent with regard to age, duration of diabetes, socioeconomic status, and glycosylated hemoglobin. Frequency of BG measurement was similar in both groups during both weeks. The mean BG value reported in the week prior to intervention was similar for the groups. However, analyses of the post-intervention BGs revealed that subjects in the low-demand group reported significantly higher BGs compared to pre-intervention and to subjects in the high-demand group. These findings suggest that self-monitoring and reporting of BG is a social behavior that is affected by the demand characteristics of the interpersonal patient-health provider relationship. Because optimal treatment planning for individuals with diabetes requires accurate BG records, care must be taken to interpret them in light of the social demand characteristics associated with clinical assessment.     

Preventing Substance Abuse Among American-Indian Adolescents: A Bicultural Competence Skills Approach

Tobacco, alcohol, and drug use are problems for American-Indian people. We reviewed these problems and the explanations for them and described a bicultural competence skills approach for preventing substance abuse with American-Indian adolescents. Data from a study of that approach suggest its efficacy with American-Indian youth. At posttest and a 6-month follow-up, American-Indian subjects who received preventive intervention based on bicultural competence skills concepts improved more than did American-Indian subjects in a no-intervention control condition on measures of substance-use knowledge, attitudes, and interactive skills, and on self-reported rates of tobacco, alcohol, and drug use. Our findings have implications for future substance-abuse prevention research with American-Indian people.     

An "Epidemic" Model of Adolescent Cigarette Smoking

The prevalence of regular smoking increases rapidly during adolescence. We applied modeling methods from the study of epidemic infectious disease to smoking behavior. Our "epidemic" models dealt with the process of transition among four states: nonsmoker (susceptible), trier (exposed), regular smoker (infected), and ex-smoker (recovered). The best fitting model was one in which the transition from nonsmoker to trier was a social contagion process where nonsmokers contacted either triers or regular smokers. All other transitions were treated as constant rate processes in which a constant proportion of eligible individuals made the transition in a given year. The recursive equation model embodying these assumptions was able to predict accurately the proportion of adolescents in each state in Grades 6–11. Our results support a "stage" model of smoking, suggesting that different psychological and physiological processes are involved in the initiation of smoking than in developing a habit of regular smoking. A possible sex difference was found in the non-contact transition between trier and smoker states, with the transition being more probable in females than in males.     

Cuing effects and associative information in recognition memory

Item recognition requires discrimination of studied words from nonstudied words. Associative recognition requires subjects to discriminate studied word groups from recombinations of words from different groups. Cued recognition requires the same old-new discrimination as item recognition, but list items are presented as cues along with the test item. The results from three experiments show (1) little or no effect of cuing for low-frequency words, but (2) positive cuing effects for high-frequency words; (3) increasing levels of overall performance with increases in study time, but (4) unchanging effects of cuing with study time; and (5) stronger positive cuing effects for two cues than for one cue. Five models (Independent Cue Model, Matrix model, MINERVA 2, SAM, and TODAM) were fit to the data of Experiment 1. Each model has trouble with at least one aspect of the results. Theoretical implications and modifications are discussed at length.     

Premissary relevance

Premissary relevance is a property of arguments understood as speech act complexes. It is explicable in terms of the idea of a premise's lending support to a conclusion. Premissary relevance is a function of premises belonging to a set which authoritatively warrants an inference to a conclusion. An authoritative inference warrant will have associated with it a conditional proposition which is true— that is to say, which can be justified. The study of the Aristotelian doctrine of topoi or argument schemes may contribute to the task of identifying authoritative warrants.     

Why the Principle of the Identity of Indiscernibles is not contingently true either

Faced with strong arguments to the effect that Leibniz'sPrinciple of the Identity of Indiscernibles (PII) is not a necessary truth, many supporters of the Principle have staged a strategic retreat to the claim that it is contingently true in this, the actual, world. The purpose of this paper is to examine the status of the various forms of PII in both classical and quantum physics, and it is concluded that this latter view is at best doubtful, at worst, simply wrong.I would like to thank Michael Redhead and an anonymous referee for several useful suggestions and criticisms relating to the earlier version of this paper. I must also acknowledge the support given by the Centre of Logic, Epistemology and History of Science of the University of Campinas and the Brazilian National Council for Scientific and Technological Development in the later stages of the preparation of this work.     

Mental health expert witnesses: Of science and crystal balls

This article reviews the history of and basis for mental health testimony. It surveys the roles of such experts in the legal system and the concomitant problems with current approaches. Finally, it suggests specific reforms that may improve the use of mental health experts in legal proceedings.     

Teaching self-treatment of cold symptoms to an anoxic brain injured adult

Traumatic brain injury can result in behavioral and physical deficits that require intensive post-acute residential rehabilitation. Behaviors targeted by such programs include basic self-care and living skills. We examined the efficacy of a behavioral training strategy to teach appropriate medical treatment of four different groups of simulated cold symptoms to an anoxic brain injured adult. The strategy included instructor prompting and feedback in the use of written task analyses and picture cues as self-administered prompts. Subsequent to baseline, the participant used written generic task analyses combined with picture cues and then, if necessary, written specific task analyses combined with picture cues to prompt appropriate self-treatment of the four types of colds. Written individualized task analyses, tailored to participant errors, were used to fade specific task analysis prompts and transfer stimulus control to the discriminative stimuli present in the picture cues. A multiple baseline design across responses showed that skill acquisition did not occur after generic task analysis training, but did so after specific task analysis training. The participant responded to all four types of colds for three consecutive trials at 100% correct under baseline conditions. Follow-up results indicated that transfer of stimulus control to the cold symptoms simulated by the picture cues alone did not maintain over time. Correct responding was retrained using generic and, if necessary, individualized task analysis training conditions.