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.     

Orientation discrimination and cortical function in the human newborn

There is some controversy concerning whether or not the visual abilities of the newborn are mediated entirely through subcortical pathways or whether the visual cortex is functioning at birth. A critical test of cortical functioning is discrimination of orientation: orientation-selective neurons are found in the visual cortex but not in subcortical parts of the visual system. An experiment is described in which newborn infants were habituated to a square-wave grating oriented 45 degrees from vertical. After habituation, significant preferences for the novel, mirror-image, grating were found, a result which argues for some degree of visual cortical functioning at birth.     

Two forms of persistence in visual information processing

Iconic memory, which was initially regarded as a unitary phenomenon, has since been subdivided into several components. In the present work we examined the joint effects of two such components (visible persistence and the visual analog representation) on performance in a partial report task. The display consisted of 15 alphabetic characters arranged around the perimeter of an imaginary circle on the face of an oscilloscope. The observer named the character singled out by a bar-probe. Two factors were varied: exposure duration of the array (10, 50, 100, 150, 200, 300, 400 or 500 ms) and duration of blank period (interstimulus interval, ISI) between the termination of the array and the onset of the probe (0, 50, 100, 150, or 200 ms). Performance was progressively impaired as both exposure duration and ISI were increased. The results were explained in terms of a probabilistic combinatorial model in which the timecourses of visible persistence and of the visual analog representation are regarded as time-locked to the onset and to the end of stimulation, respectively. The impairing effect of exposure duration was attributed to the relatively high spatial demands of the task that could be met optimally by information in visible persistence (which declines as a function of exposure duration), but less adequately by information in the visual analog representation. A second experiment, employing a task with lesser spatial demands, confirmed this interpretation.