Deciding in the best interest of clients with dementia: the experience of public guardians

We conducted an in-depth interview study of public guardians in three local jurisdictions in the state of Maryland to explore the decision-making process utilized by court-appointed public guardians making medical and EOL care decisions on behalf of their clients with dementia. Overall, public guardians appeared to make their decisions in the context of relevant ethical principles and relevant case law and state statute, and the basis upon which they made informed decisions was dependent on their training and experience. The stated goal of public guardians is to make decisions that they believe are in the best interest of their clients. In the case of a healthcare decision, their goal is to maximize quality of life; and in the case of an EOL care decision, their goal is to minimize pain and suffering. In general, public guardians gathered information in order to identify previous preferences of their now-incapacitated clients, so that they could develop a preference profile to assist both an initial decision on whether an individual ought to have a court-appointed public guardian, and with healthcare and EOL decisions once an appointment was made. When guardians were unable to develop a preference profile for a particular client, they relied on past decisions in similar situations. Healthcare and EOL decisions were most often triggered by a recommendation by the client's healthcare provider. Once a decision-point was identified, the public guardian considered the risks and benefits of the proposed intervention in light of the client's current condition. At times the guardians reviewed informational resources such as textbooks and the Internet. In addition, most guardians sought advice from a medical consultant who is available to all public guardians in Maryland. Some guardians sought the advice of this medical consultant only when faced with more complex decisions. Guardians challenged physicians' recommendations when they believed the physicians were recommending an intervention that was not in the best interest of the client--that is, they advocated against either overtreatment or undertreatment. Ultimately, guardians took particularly difficult issues to the court and obtained a judge's opinion.     

Exploring the Association between Aggression and Anxiety in Youth: A Look at Aggressive Subtypes,Gender, and Social Cognition

We examined the associations among dimensions of aggression and anxiety disorder symptoms in an ethnically diverse community sample of youth (N = 83; 46% female). Research supports the existence of four aggressive subtypes (i.e., reactive overt, reactive relational, proactive overt, and proactive relational), and past research has found associations between relational aggression and anxiety, as well as between reactive aggression and anxiety. However, past studies have not examined the associations among anxiety symptoms and the combined subtypes of aggression mentioned above. Results of our study provided support for an association between anxiety and reactive relational aggression. In addition, gender was found to moderate the association, in that males with high anxiety showed higher levels of reactive relational aggression than males with low anxiety and girls. Further, we found that socially based negative cognitive errors mediated the association between reactive relational aggression and anxiety. Results are discussed in terms of clarifying gender differences in aggression, treatment implications, and the need for longitudinal studies to delineate the temporal associations between aggression and anxiety.     

The Influence of Organizational Culture on Work‐Related Personality Requirement Ratings: A multilevel analysis

The effects of organizational culture on job incumbents' ratings of work‐related personality requirements were investigated. Data collected from 270 customer service representatives working within 37 mobile phone service companies in China demonstrated significant between‐organization differences and sufficient within‐organization agreement on two dimensions of work‐related personality requirements, achievement orientation and conscientiousness, to suggest that these work‐related personality requirements can be interpreted as organizational‐level constructs. Furthermore, incumbents' ratings of the two personality requirements were positively related to two corresponding dimensions of organizational culture, achievement‐oriented culture and integrity‐oriented culture, respectively, and as predicted, both were positively associated with team‐oriented culture. Further analyses revealed that team‐oriented culture appeared to play a particularly salient role in predicting incumbents' perceptions about the importance of the two dimensions of personality requirements.     

False recognition following study of semantically related lists presented in jumbled word form

Three experiments explored a jumbled word effect in false recognition. Lists of theme-related items were presented in word or nonword form. Results indicated that critical lures semantically related to studied items were falsely recognised regardless of whether they were presented as words or nonwords. High false recognition rates to either SLEEP or SELEP following study of an appropriate theme list of items in nonword form should only occur if nonwords are recoded at study. With study conditions conducive to recoding, jumbled words induced false recognitions based on semantic associations among their respective base words. Disrupting a recoding process by creating "difficult" letter rearrangements for jumbled words (Experiment 2) appeared to eliminate the false recognition effect. In Experiment 3, presentation durations ranged from 110 ms to 880 ms. Although there was little evidence of a semantic false recognition effect at the fastest presentation rate, the brief durations appeared to be effective in eliminating the effect when items were studied in nonword form. These results appear to be consistent with an encoding activation/retrieval monitoring model.     

Spirituality and Subjective Religiosity among African Americans, Caribbean Blacks and Non-Hispanic Whites

Patterns and correlates of self-perceptions of spirituality and subjective religiosity are examined using data from the National Survey of American Life, a nationally representative study of African Americans, Caribbean Blacks and non-Hispanic Whites. Demographic and denominational correlates of patterns of subjective religiosity and spirituality (i.e., religious only, spiritual only, both religious/spiritual and neither religious/spiritual) are examined. In addition, the study of African Americans and Caribbean Blacks permits the investigation of possible ethnic variation in the meaning and conceptual significance of these constructs within the U.S. Black population. African Americans and Caribbean Blacks are more likely than Non-Hispanic Whites to indicate that they are "both religious and spiritual" and less likely to indicate that they are "spiritual only" or "neither spiritual nor religious." Demographic and denominational differences in the patterns of spirituality and subjective religiosity are also indicated. Study findings are discussed in relation to prior research in this field and noted conceptual and methodological issues deserving further study.     

Reducing rapid eating in teenagers with autism: use of a pager prompt

This study assessed the effects of a vibrating pager for increasing the duration of meal consumption in 3 teenagers with autism who were observed to eat too quickly. Participants were taught to take a bite only when the pager vibrated at predetermined intervals. A reversal design indicated that the vibrating pager successfully increased the total duration of mealtime, thereby slowing the pace of consumption for all 3 participants.     

Clarifying the nature of the distinctiveness by domain interaction in conceptual structure: comment on Cree, McNorgan, and McRae (2006)

The conceptual structure account of semantic memory (CSA; L. K. Tyler & H. E. Moss, 2001) claims that feature correlation (the degree to which features co-occur) and feature distinctiveness (the number of concepts in which a feature occurs) interact with domains of knowledge (e.g., living vs. nonliving) such that the distinctive features of nonliving things are more highly correlated than the distinctive features of living things. Evidence for (B. Randall, H. E. Moss, J. M. Rodd, M. Greer, & L. K. Tyler, 2004) and against this claim (G. S. Cree, C. McNorgan, & K. McRae, 2006) has been reported. This comment outlines the CSA, discusses Cree et al.'s (2006) critiques of the Randall et al. (2004) experiments and the CSA, and reports new analyses of property norm and behavioral data, which replicate the results reported by Randall et al. (2004).     

The role of explicit and implicit standards in visual speed discrimination

Five experiments were designed to investigate visual speed discrimination. Variations of the method of constant stimuli were used to obtain speed discrimination thresholds in experiments 1, 2, 4, and 5, while the method of single stimuli was used in experiment 3. The observers' thresholds were significantly influenced by the choice of psychophysical method and by changes in the standard speed. The observers' judgments were unaffected, however, by changes in the magnitude of random variations in stimulus duration, reinforcing the conclusions of Lappin et al (1975 Journal of Experimental Psychology: Human Perception and Performance 1 383 394). When an implicit standard was used, the observers produced relatively low discrimination thresholds (7.0% of the standard speed), verifying the results of McKee (1981 Vision Research 21 491-500). When an explicit standard was used in a 2AFC variant of the method of constant stimuli, however, the observers' discrimination thresholds increased by 74% (to 12.2%), resembling the high thresholds obtained by Mandriota et al (1962 Science 138 437-438). A subsequent signal-detection analysis revealed that the observers' actual sensitivities to differences in speed were in fact equivalent for both psychophysical methods. The formation of an implicit standard in the method of single stimuli allows human observers to make judgments of speed that are as precise as those obtained when explicit standards are available.     

Dimensionality and Validity of a Structured Telephone Reference Check Procedure

A structured telephone reference check (STRC) was developed to assess three job-relevant personality/interpersonal dimensions (Conscientiousness, Agreeableness, customer focus) for a family of entry-level, customer-contact jobs within a service organization. The procedure was designed to be brief (a 10–15 minute telephone call with each referee) and easy to administer by untrained recruitment staff. Confirmatory factor analyses on referee ratings for 223 applicants indicated that referees were able to adequately discriminate between dimensions of applicants' past performance. A predictive, criterion-related validation study on those applicants who were hired demonstrated that the STRC predicted supervisory ratings of job performance (   r = .25, p < .01,  uncorrected; .36 corrected for range restriction and criterion unreliability). No evidence was found that referees with shorter working relationships with applicants provided less valid ratings.