The Patient Self-Determination Act and Advance Directives: Snapshots of Activities in a Tertiary Health Care Center

This study describes the results of a retrospective review of patients' charts who had an advanced directive (AD) and who were hospitalized in a tertiary, acute care teaching hospital. The purpose of the review was to understand from clinical, sociological, ethical and legal perspectives the nature and utility of ADs. Findings and implications of the review are discussed in terms of: patient demographics; diagnoses; quality of ADs; influence of ADs on clinical decisions; and legal aspects of ADs.     

Some correlates of health locus of control among multicultural individuals

The relationship of locus of control to depression, anxiety, hostility, and physical health was assessed in a sample of multicultural college students (N = 162). Powerful Others Health Locus of Control was correlated with depression, anxiety, hostility, and recent physical symptoms while Chance Health Locus of Control (CHLC) was correlated with all of the above as well as chronic physical symptoms and major health problems. When controlling for a variety of health risk factors (viz., age, sex, body mass, exercise, smoking, salt, alcohol, and caffeine), only CHLC remained significant in the physical health models. Results support the cognitive model of mental health which emphasize the importance of adaptive beliefs. Specifically, they suggest that issues about control are related to negative affect and indicate that the often-cited relationship of an external locus of control to depression and anxiety also holds for hostility. The findings do not, however, support the view that anxiety and depression are associated with different types of external locus of control but rather suggest a unified set of locus of control beliefs underlying the three types of negative affect. In addition, evidence is provided for the external validity of the Multidimensional Health Locus of Control (MHLC) Scales with respect to mental health. Further, the results indicate that belief about one’s health may play a significant role in one’s physical health and that the health behavior model of the relationship between locus of control and physical health is insufficient to explain the relationship. As the Chance and Powerful Others MHLC scales were not related to health habits in this sample but were related to mental health (viz., depression, anxiety, and hostility), locus of control beliefs may be related to physical health via their relationship with mental health.     

CLASSWIDE PEER TUTORING: AN INTEGRATION STRATEGY TO IMPROVE READING SKILLS AND PROMOTE PEER INTERACTIONS AMONG STUDENTS WITH AUTISM AND GENERAL EDUCATION PEERS

A multiple baseline design across subjects with a reversal was used to examine the effects of classwide peer tutoring relative to traditional reading instruction on reading skills and social interaction time for 3 high-functioning students with autism and their typical peers in integrated, general education classrooms. Traditional reading instruction consisted largely of teacher-led instruction with individual student participation and seat work. Classwide peer tutoring consisted of 25 to 30 min of well-specified instruction in which tutor—learner pairs worked together on a classwide basis on reading fluency and comprehension skills. All students participated in 15- to 20-min unstructured free-time activities immediately following reading instruction. Results of reading assessments demonstrated that classwide peer tutoring increased reading fluency and correct responses to reading comprehension questions for students with autism and their peers. The procedure further increased the total duration of free-time social interactions for students with autism and typical peers, with individual variation in performance.     

DOUBLE DISSOCIATION BETWEEN MEMORY SYSTEMS UNDERLYING EXPLICIT AND IMPLICIT MEMORY IN THE HUMAN BRAIN

Abstract— Amnesic patients have impaired explicit memory that is evident in poor recall and recognition of words, yet can have intact implicit memory for words as measured by repetition priming, the enhanced efficiency for reprocessing those word's. The dissociation between explicit and implicit memory for words is a fundamental characteristic of normal cognition that could reflect two different functional architectures of the human brain two separate processing systems or two levels of operation of a single system with implicit memory less demanding of that system. We present a patient who has a lesion in the right occipital lobe and who showed intact explicit and impaired implicit memory for words. The deficit was specific to visual priming. The double dissociation between explicit and implicit visual memory for words indicates that separate processing systems mediate these two forms of memory, and that a memory system in right occipital cortex mediates implicit visual memory for words.     

Illusions of Safety in a Risky World: A Study of College Students' Condom Use

The role that costs, benefits, and perceptions of invulnerability play in condom use was examined in a sample of students ( N = 211) at 4-year and 2-year colleges. In multiple regression analyses, past condom use was related to relative invulnerability, low present risk, and inexperience. Less intended condom use was associated with high perceptions of relative invulnerability and low perceptions of present risk. It appears that many college students feel protected from HIV because they judge their current sexual environment to be safe due to monogamy, sexual history taking, and the ability to tell a partner's HIV status. Independent of that, feelings of relative invulnerability are associated with more condom use—perhaps an accurate judgment of past risky behavior.