The hospice: Humane care for the dying

The hospice movement arose as a reaction to the dehumanizing atmosphere of acute-care hospitals, where excessive utilization of life support equipment deprived dying patients of a meaningful vision of their destiny. Respecting the spiritual quest of the terminally ill for wholeness and dignity, the hospice concept prescribes the rendering of compassionate and pastoral care by a benevolent community of family, health care staff, friends, and clergy. Approximately 800 hospice programs are currently evolving in the United States. St. Mary's (formerly “Hillhaven”) Hospice in Tucson, Arizona, offers the most comprehensive program of services, including home care, inpatient care, and artistic media through which the dying express their creativity. Numerous demonstration projects funded by several government agencies, principally the Health Care Financing Administration (HCFA), are expected to result in the legislative actions eliminating barriers to reimbursement of the cost of hospice services by Medicare, Medicaid, and other third-party payers. Existential analysis reveals the value of religion and spiritual support in enabling the dying to banish anxiety and muster the hope requisite for fully appreciating the authentic meaning of their destiny.     

Treatment of Poststroke Anxiety in an Older Adult Male: A Single-Case Analysis

A single-case analysis was carried out to study the nonpharmacological treatment of post-stroke anxiety in an older adult male. The intervention consisted of a biofeedback-assisted program of autogenic training; efficacy was demonstrated using multiple discontinuations and reinstatements of treatment. Physiological indices and self-report measures of anxiety and depression documented treatment success, although a moderate increase in fear was evident on the Fear Survey Schedule II at the final follow-up assessment.     

Behavioral Gerontology: State of the Science

Baer, Wolf and Risley's (1968) dimensions of applied behavior analysis are used as an organizing framework to review and discuss current research on the application of behavioral principles to the solution of social problems faced by older adults. Implications for future research are discussed.     

Contribution of ankle, knee, and hip joints to the perception threshold for support surface rotation

The purpose of the present experiment was to investigate the extent to which subjects can perceive, at very slow velocities, an angular rotation of the support surface about the medio-lateral axis of the ankle, knee, hip, or neck joint when visual cues are not available. Subjects were passively displaced on a slowly rotating platform at .01, .03, and .05 deg/sec. The subjects’ task was to detect movements of the platform in four different postural conditions allowing body oscillations about the ankle, knee, hip, or neck joint. In Experiment 1, subjects had to detect backward and forward rotation (pitching). In Experiment 2, they had to detect left and right rotations of the platform (rolling). In Experiment 3, subjects had to detect both backward/forward and left/right rotations of the platform, with the body fixed and the head either fixed or free to move. Overall, when the body was free to oscillate about the ankle, knee, or hip joints, a similar threshold for movement perception was observed. This threshold was lower for rolling than for pitching. Interestingly, in these postural conditions, an unconscious compensation in the direction opposite to the platform rotation was observed on most trials. The threshold for movement perception was much higher when the head was the only segment free to oscillate about the neck joint. These results suggest that, in static conditions, the otoliths are poor detectors of the direction of gravity forces. They also suggest that accurate perception of body orientation is improved when proprioceptive information can be dynamically integrated.     

Sexually dimorphic effect of an acute smoking manipulation on skin resistance but not on heart-rate during a cognitive verbal task

In a two-day, two-session experiment where smokers male and female college-student subjects worked on a cognitive verbal task during either the first or second day, and on a cognitive spatial task on the second or first day, smoking was manipulated as an acute independent variable by requiring 10+ hours of pre-experimental abstention, and providing a cigarette during the 15-minute rest period between the two sessions. Non-smoker female and male subjects underwent the same experiment, and hence served as controls for the effects of this acute-smoking manipulation. Overall adaptation (decreased arousal) to the experiment was manifested in a significant increase in skin resistance level (SRL) in all subjects, but when this adaptation effect was statistically controlled, there was a significant smokers by sex interaction during the verbal task only, such that SRL was increased by the cigarette in males, but decreased in females. In contrast, the same analysis indicated only a marked increase in heart-rate (HR) due to smoking, which was unaffected either by sex or by whether the task was the verbal or the (easier) spatial one. We interpret the SRL results as reflecting a sex difference in the direction of transient psychological arousal, and discuss it in relation to evidence in the literature based on self reports, and to evidence (based on HR in this study and on blood pressure in other studies) on physiological (cardiovascular) arousal.     

Be is a raising verb: Psycholinguistic evidence

Psycholinguistic evidence is reported supporting the proposal from theoretical linguistics that the D-structure representation of English copular sentences likeJohn is a fool, The man is happy, etc., is [S [NP e] [vp BE [sc NP XP]]], containing a small clause (SC), rather than [s NP [vp BE XP]], in other words, thatbe is a raising verb. Response times to lexical targets following unaccusative, passive, intransitive, and transitive sentences were compared with response times to lexical targets following corresponding copular sentences. A raising analysis of copular sentences specifies a post-verbal NP-trace of the (raised) NP subject at S-structure. This trace should facilitate the response time to a post-sentence presentation of the head noun of the subject NP, causing copular sentence response times to pattern with the response times for corresponding unaccusatives and passives, which also contain such traces. A traditional nonraising analysis specifies no trace at S-structure. Response times to copular sentences should then pattern with corresponding intransitives and transitives, which also do not contain traces. The observed response-time patterns confirmed the raising analysis.This study was conducted at the National Technical Institute for the Deaf at Rochester Institute of Technology, in the course of an agreement with the U.S. Department of Education.     

A method for determining the aversive threshold in the rat using repeated measures: Tests with morphine sulfate

The procedure described here provides an objective automated technique for the psychophysical assessment of the aversive threshold and allows the animal Ss to serve as their own controls. Sensitivity to drug effects, as well as comparisons between drugs, using the same animals are possible also. Using a rectangular tilt cage, the aversive threshold to grid shock was defined as that intensity avoided 75% of the time. Each shock intensity (30, 60, 90, 120, and 150 microA) was presented for 5 min on one side of the cage and then switched to the other side for 5 min, thereby forcing the animal to sample each shock intensity. Aversive thresholds were determined daily for each rat. The analgesic effects of morphine sulfate were compared to saline. Animals were tested for 3 days at each morphine dose level (2, 4, 8, and 16 mg/kg). Each 3-day morphine series alternated with 3 days of testing under saline. Significant differences were detected between saline and morphine at 4, 8, and 16 mg/kg.     

A comparative study of proprietary and nonproprietary vocational training graduates

Questionnaires were sent to 13,549 graduates of four types of proprietary and nonproprietary vocational training programs in four selected metropolitan areas of the United States. Initial responses were received from 5,215 graduates, a response rate of 38.5%. The survey featured an intensive follow-up to reach and estimate the characteristics of the nonrespondent population. Substantial differences favoring nonproprietary programs were found between proprietary and nonproprietary graduates in terms of economic gains following graduation and expressed satisfaction. Nevertheless, both types of programs were found to be generally effective in producing graduates with marketable skills; post-training salaries were high enough to indicate that the training was cost effective in all except proprietary computer training programs. The results supported several recommendations regarding the necessity for uniform standards of accountability in the regulation of vocational training programs, whether they are public or private.