PROMPTING ONE LOW-FAT,HIGH-FIBER SELECTION IN A FAST-FOOD RESTAURANT

Evidence increasingly links a high-fat, low-fiber diet to coronary heart disease and certain site cancers, indicating a need for large-scale dietary change. Studies showing the effectiveness of particular procedures in specific settings are important at this point. The present study, using an A-B-A-B design and sales data from computerized cash registers, replicated and extended previous work by showing that inexpensive prompts (i.e., signs and fliers) in a national fast-food restaurant could increase the sales of salads, a low-fat, high-fiber menu selection. Suggestions also are made pertinent to more widespread use of the procedures.     

Functional measurement approach to self-estimation in multiattribute evaluation

Multiattribute analysis depends on measurement of values and weights. Unless these measures reflect the decision maker's true values and weights, the multiattribute formula may put a less-preferred alternative in first place. To avoid such disordinality requires stringent measurement conditions: First, the values and weights must be on linear (equal interval) or ratio (known zero) scales. Second, these scales must satisfy a condition of common unit across disparate attribute dimensions. Most methods of range adjustment beg both of these measurement questions. Functional measurement theory can solve both problems and so can be useful in multiattribute analysis. Past work has established the operation of a general cognitive algebra as an empirical reality. The averaging model, in particular, makes possible the definition and estimation of weights and values as distinct psychological parameters. It can also solve the problem of common unit. Cognitive algebra thus provides a grounded theoretical foundation on which to develop self-estimation methodology, in which decision makers provide direct estimates of their values and weights. The logic is straightforward. Functional measurement can analyze global judgments to obtain validated psychological scales. These scales may then be used as validational criteria for the self-estimates. Procedures to eliminate biases in the self-estimates can thus be tested and refined in well-learned multiattribute tasks, such as judgments of meals, in which global judgments are trustworthy. Once developed, such self-estimation procedures may be used with some confidence for general multiattribute analysis. A number of studies from 20-odd years of work on the theory of information integration are summarized to show good, although not unmixed promise for self-estimation.     

Sur l'omniprésence du mensonge dans le discours

Three levels are proposed to explain lying as a process in discourse production, to characterize different types of lies and to distinguish them from mistakes, ignorance and forgetting as well fr from ill-timed or irrelevant utterances.

     

Genetics and adoption: Forming a partnership

Genetic issues are demanding more attention in the area of public health. Adoption agencies and policymakers are beginning to address these issues where they relate to the adoption process and to the many families involved in adoption in this country. Genetic counselors need to play an active role as both educators of and consultants for adoption professionals and the families with whom they work. To facilitate a partnership between genetics and adoption we have developed a workshop intended to educate adoption professionals about the lifelong implications of genetic conditions on the adoption triad.     

The health needs of the majority versus the health needs of the individual: The reorganization of medical education in Colombia

The challenge of excellence in community health services has been taken up by medical educators in Colombia. Confronted with a nation where the primary indicators of disease mortality and morbidity (cardiovascular disease and infant mortality) were characteristic of First and Third World patterns, respectively, the Ministry of Health and La Asociacion Colombiana de Facultades de Medicina (ASCOFAME), representatives of institutions of medical education, have collaborated to conduct a needs assessment of the country's health needs and devised an implementation plan designed to better address the needs of the majority of that nation's people.As a model, the Colombian reorganization of medical education is an example which could be emulated by the U.S. where policy makers are struggling with troublesome questions of cost, equity and quality.     

MAINTAINING PERFORMANCE OF AUTISTIC CLIENTS IN COMMUNITY SETTINGS WITH DELAYED CONTINGENCIES

To facilitate the classroom and workshop integration of three autistic clients, we examined the feasibility of teaching them to respond appropriately without the continual presence of specially trained treatment providers. Within a multiple baseline design, a 4-step treatment process was implemented to promote durable responsive performance. Results indicated that the therapist could be removed from the treatment environment and that appropriate behavior could be successfully maintained in community settings with only infrequent and delayed contingencies.     

HUMAN WHOLENESS IN LIGHT OF FIVE TYPES OF PSYCHIC DUALITY

Abstract. Five types of psychic duality are distinguished: bipolarity, bimodality, contrariety, dualism, and the coincidentia op–positorurn. Bipolarity is the basic division of the psyche into egoic and nonegoic (physico–dynamic) poles. Bimodality is the division of egoic functioning into active and receptive modes. Contrariety is the division of the nonegoic sphere into opposing sympathetic and parasympathetic systems. Dualism is the organization imposed upon the bipolar structure by primal repression. And the coincidentia opositorum is the condition of psychic integration that would emerge were dualism to be transcended and the bipolar structure (together with the bimodal and contrarietal structures) unified into a higher whole.     

INCREASING APPOINTMENT KEEPING BY REDUCING THE CALL-APPOINTMENT INTERVAL

We examined the effect of reducing the interval between a patient's call for an appointment and the appointment itself. In Experiment 1, patients calling a family planning unit of a public health department were assigned appointments within either 1 or 3 weeks of their call. Data on patient “shows” and “no-shows” were recorded weekly for 6 weeks. Show rates for those in the 1-week appointment group were significantly higher than those in the 3-week group. In Experiment 2, patients were assigned to appointment dates either the next operating clinic day (next-day group) or 2 weeks from the call date (2-week group). Show rates for those in the next-day group were significantly better than show rates for patients in the 2-week group. Clinic productivity, time spent with patients, and consumer satisfaction were also assessed. Implications for appointment scheduling are discussed.     

Depressed mood and environmental mastery as potential pathways linking family relationship quality and disease self-management for African Americans with hypertension

African Americans are at significantly greater risk of hypertension and worse cardiovascular outcomes than other racialized groups, yet hypertension intervention effects remain limited. Thus, it is necessary to understand the potential mechanisms whereby interventions may be more effectively targeted to improve health. Supported by prior research evidence and guided by the Biobehavioral Family Model, this study examined associations between family relationship quality, psychological wellbeing, and self-management behaviors for African Americans with hypertension. Data were pooled from three Midlife Development in the U.S. projects, resulting in a sample of 317 African Americans (63.4% female, M_age = 53.32) with self-reported high blood pressure in the past 12 months. We tested four cross-sectional multiple mediator models, with depressed mood and environmental mastery mediating associations between family strain and exercise, smoking, problematic alcohol use, and stress-eating. Environmental mastery mediated the association between greater family strain and decreased odds of achieving recommended exercise levels; greater odds of reporting problematic alcohol use; and greater stress-eating. Though family strain was associated with depressed mood in each model, this variable did not serve as an indirect pathway to self-management behaviors. Family strain, and the potential pathway identified via environmental mastery, may be a meaningful predictor of disease self-management for African Americans with hypertension. Longitudinal studies are needed to examine directionality and to support intervention trials for improving self-management and hypertension outcomes.