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191.
Recent legislative and regulatory developments have focused attention on older adults' capacity for involvement in health care decision-making. The Omnibus Budget Reconciliation Act of 1987 (OBRA 87) focused attention on the rights of nursing home residents to be involved in health care decision-making to the fullest extent possible. This article uses data from the 1987 National Medical Expenditure Survey (NMES) to examine rates of incapacity for health care decision-making among nursing home residents. Elements of the Oklahoma statute were used to operationalize decision-making incapacity: disability or disorder, difficulty in decision-making or communicating decisions, and functional disability. Fifty-three percent of nursing home residents had a combination of either physical or mental impairment and an impairment in either self-care or money management. The discussion focuses on the policy and practice implications of significant rates of incapacity among nursing home residents. 相似文献
192.
John D. Teasdale Barbara H. Dritschel Melanie J. Taylor Linda Proctor Charlotte A. Lloyd Ian Nimmo-Smith Alan D. Baddeley 《Memory & cognition》1995,23(5):551-559
Stimulus-independent thoughts (SITs) are streams of thoughts and images unrelated to immediate sensory input. Four experiments examined the contribution of aspects of working memory to production of SITs. In Experiments 1 and 2, interventions that were targeted on, respectively, phonological and visuospatial components of working memory both interfered with production of SITs, but there was evidence that these tasks also made demands on central executive resources. Experiments 3 and 4 specifically examined the hypothesis that production of SITs and control of nonproceduralized tasks both depend on central executive resources, and so should show mutual interference. In Experiment 3, prior practice on pursuit rotor and memory tasks reduced the interference with SITs from concurrent task performance. In Experiment 4, randomness within a task involving random-number generation was less when SITs were being produced concurrently than it was when they were not. The results suggest that production of SITs depends on central executive resources. 相似文献
193.
Progressive supranuclear palsy (PSP) is the epitome of a subcortical dementia process. Due to its relative rarity, there is only a small literature on the neuropsychological consequences of PSP. The findings to date demonstrate that PSP patients have dramatically slowed information processing and motor execution, rapid forgetting, problems in orienting attentional resources, and difficulty in planning and shifting conceptual sets. The pattern and severity of these deficits are unique to PSP and suggest that the study of PSP patients can provide a special insight into brain-behavior relations. 相似文献
194.
A brief classroom demonstration designed to introduce students to the concepts of self-monitoring, reactivity, and interobserver agreement is presented. The demonstration provides students with opportunities to monitor their own behavior, record the behavior of others, and calculate interobserver agreement percentages. Results of using the demonstration with students from two classes are presented. 相似文献
195.
A methodology for the quantitative evaluation of observed workload was proposed. The model was designed to provide point estimations of observed workload at any time during the performance of a set of tasks. The model was also designed to provide information about the task-scheduling strategies used to complete a set of tasks. The proposed model was then tested with data from a full mission flight simulation. The model predictions correlated significantly with expert ratings of workload management made during the flight simulation. The model was also able to distinguish between low- and high-performing aircrews when performance was based on the number of errors made during flight simulations. 相似文献
196.
The purpose of this study was to determine the extent to which lobectomy affects ability to discriminate facial identity or facial expression. Fifteen right temporal, 15 left temporal, 5 right frontal, and 4 left frontal lobectomy patients, pair-matched for age, sex, and education to normal control subjects, participated in this study. Tasks included a Facial Identity Matching Task and a Facial Affect Matching task. The lobectomized patients as a whole were significantly impaired on both tasks (22% decrement in performance). The patients made twice as many errors resulting from perseveration of response-set of the first condition (identity or emotion matching) into the second condition. The site of lobectomy did not influence general performance on any one task or selective performance on any subset of affective categories. It was concluded that all four brain regions play a significant and equal role in face processing, and that circuits more specifically dedicated to visual face processing, which are responsible for hemispheric dominance affects and affect/identity dissociations, are probably located more posteriorly in the brain. Finally, it was concluded that perseveration of acquired habit may, under specific conditions, characterize temporal lobe dysfunction just as much as frontal lobe dysfunction. 相似文献
197.
198.
Sederer LI 《Behavioral sciences & the law》1994,12(4):367-378
Managed care and organized systems of care are restructuring the delivery of care in the United States. As care is reorganized, physician practice styles, autonomy, and compensation are undergoing profound changes. To successfully integrate physicians into the new managed systems of care, their organizational relationship to and their compensation within these systems must be carefully considered. This paper first explores physician motivation as it is related to compensation. The paper then describes a variety of emerging organizational designs aimed at aligning the interests of physicians and hospitals. The author considers fully integrated, physician-hospital organizations with target income compensation arrangements to be most suitable to the collective success of professionals and organized systems of care. The paper concludes with a discussion of the many dilemmas and challenges posed by the intertwining of managed care, organized networks of care, and professional compensation. 相似文献
199.
Seven undergraduates participated in a concurrent-choice experiment with monetary reinforcers. Response-independent analogues of variable-interval and variable-ratio schedules were used to assess whether subjects would maximize reinforcement rate. The optimal pattern of behavior, in terms of maximizing reinforcement rate, involved a large bias toward the ratio alternative, with only occasional sampling of the interval schedule. Most experiments with pigeons, however, demonstrate matching of response rates to reinforcement rates, with only slight biases for the ratio schedule. Although subjects in the present experiment allocated more time to the ratio alternative than required by matching, the magnitude of the bias did not approximate that predicted by a maximizing account. After exposure to clock stimuli correlated with the operation of each schedule, 1 subject's behavior did show a substantial level of bias, increasing the total number of reinforcers obtained, and lay at a point between the predictions of matching and maximizing. The other subjects, however, continued to respond less optimally. The present results can be accounted for by a view of matching that incorporates the effects of delayed reinforcement. 相似文献
200.