Guidelines for Writing Letters to Patients

Patient letters provide a permanent record of the genetic counseling that was provided and are unique in medical care; rarely do other health care providers send summaries written specifically to their patients and families. We surveyed genetic counseling training program directors and found that while the acquisition of patient letter-writing skills was considered important, there were no specific guidelines made available to students. To develop letter-writing guidelines, we evaluated patient letters, reviewed references on professional correspondence, surveyed the medical literature, and worked with a writing consultant. The guidelines we subsequently developed and present here include a format for writing patient letters, suggestions on presenting medical information in understandable terms, and wording considerations. These patient letter-writing guidelines are intended to serve as a guide for teaching students this important skill and as a resource for practicing health care professionals.     

Can men talk about problems with weight? The therapeutic implications of a discourse analytic study

This paper discusses the implications for counsellors of a discourse analytic study examining men's talk about body weight. It is argued that research in the area of problems with body has neglected the growing pressures on men to manage body as a feature of self. This research perpetuates the dominant discursive construction of men's relationship to body as unproblematic — a construction that may present many barriers to men in seeking help for any distress encountered. An analysis of men's talk is discussed in terms of the expectation that body is not problematic and the observable downplaying of any concerns acknowledged. The accountability of body as a site of regulation also emerges within the extracts presented. It is argued that this property within the accounts resonates with work highlighting the growing pressures on men to exercise control over body. The contradictions between the two discourses identified are discussed in terms of their therapeutic implications. It is postulated that male distress emerging from the growing pressures to maintain body weight may be neglected within primary care and therapeutic domains if discourses formulating such difficulties as not relevant to men remain dominant.     

Science and Religion: Getting Ready for the Future

I explore three challenges for the current dialogue between science and religion: the challenges from hermeneutics, feminisms, and postmodernisms. Hermeneutics, defined as the practice and theory of interpretation and understanding, not only deals with questions of interpreting texts and data but also examines the role and use of language in religion and in science, but it should not stop there. Results of the post‐Kuhnian discussion are used to exemplify a wider range of hermeneutical issues, such as the ideological potential of scientific concepts, the dynamics of interdisciplinarity, and the significance of the socioeconomic situatedness of science and religion. Feminist research analyzes the consequences of the interplay of masculine, feminine, and gender typologies in religion and science. Examples from the history of science as well as current scientific conceptualizations indicate that beliefs in the inferiority of woman form part of our inherited scientific, religious, and metaphysical framework. It is argued that postmodernism in its most constructive form shares the best fruits of modernity, especially of the Enlightenment, while avoiding some of its most serious mistakes. In conclusion, reflecting on the three publics engaged in the dialogue between science and religion—academe, religious communities, and societies—I offer constructive suggestions and critical observations concerning the future of this dialogue.     

Ricoeur versus Taylor on Language and Narrative

Abstract: Although Ricoeur and Taylor are often grouped together, their conceptions of language, literature, and practical reason are very different. The first half of this essay focuses on Ricoeur's theory of triple mimesis and narrative, showing how his attempt to synthesize Kant, Husserl, and structuralism results in a formalism that blocks out the ontological, hermeneutical, and historical dimensions of literature and practical reason. The second half of the essay develops Taylor's ontological conception of public imagination and illustrates the dynamics of this conception of language and interpretation by showing how literary works debate with each other over language, subjectivity, and reference. Narrative does not just order; it argues.     

An analysis of confusion errors in many-to-one matching with temporal and nontemporal samples

In experiment 1, pigeons were trained to match temporal (2, 8, and 10 s of houselight) and location (feeder light, left key, center key illumination) samples to color comparison stimuli. Red choices were correct following the 2-s and feeder light, orange choices were correct following the 8-s and center key, and green choices were correct following the 10-s and left key. Samples that were harder to discriminate (8- vs 10-s, and left vs center key) were mapped onto comparisons that were easy to discriminate (orange vs green), while samples that were easier to discriminate (2- vs 8-s, and feeder light vs left key) were mapped onto comparisons that were hard to discriminate(red vs orange). The pattern of errors for temporal and location samples indicated that these samples were not represented by a common code even though they were associated with the same comparison stimuli. In experiment 2, the same pigeons were trained with visual samples in which samples that were hard to discriminate (triangle vs circle) were mapped onto comparisons that were easy to discriminate (orange vs green), while samples that were easy to discriminate(plus vs triangle) were mapped onto comparisons that were hard to discriminate (red vs orange). Following acquisition of the visual discrimination, the temporal samples were re-introduced and many-to-one training was continued. During delay testing, the pattern of errors for temporal and visual samples was equivalent and consistent with the hypothesis that visual samples were being coded in terms of the duration appropriate for the temporal sample with which it shared a common comparison response. Data from no-sample test sessions ruled out a simple response bias explanation of the data. The properties of common codes for temporal and nontemporal events can be somewhat flexible and more complicated than previously envisaged. Received: 21 January 1998 / Accepted after revision: 5 April 1998     

The pitch of “real” and “rhetorical” questions directed by a father to his daughter: A longitudinal case study

A longitudinal study of a father and his daughter examined pitch-variation of “real” and “rhetorical” questions. Although the father asked “real” and “rhetorical” questions from the start of the recordings, he did not distinguish them through differential pitch height until the baby was 15 months old.     

TEACHING GENERATIVE USE OF SENTENCE ANSWERS TO THREE FORMS OF QUESTIONS1

Three retarded and four economically disadvantaged children were taught, through modelling and reinforcement procedures, to produce complete sentences in response to three types of questions involving changes in verb inflections. To evaluate generalization of training, new but similar questions were periodically asked, answers to which were never modelled or reinforced. Modelling and reinforcement effectively taught correct sentence answers to training questions and produced new sentence answers to questions for which no specific training had been given.     

Further considerations of theory,technique, and affect in child psychoanalysis: Two prelatency cases

The analyses of two young boys, 4½ and 5 years old, are presented. One child was severely inhibited and nearly mute; the other was disorganized, frenetic, and violent. In the context of these treatments, the author raises several questions related to clinical theory and technique, including the use of early interpretation of affect with such children; the possible benefit of verbalizing primary affects in this early interpretive work; and the roles of verbalization and affect in work with caregivers and adult patients.