Report of the Working Group on Governance and Administration

Prepared by the Working Group on Governance and Administration from the November 1995 Georgetown conference sponsored by the Association of Medical School Psychologists, this paper delineates the various trends in health care that may impact upon organizational structures for psychologists within academic medical centers. Ten variables that describe various functional issues within academic medical centers or health science centers are defined. Finally, seven organizational guidelines and recommendations pertaining to governance of psychological services are detailed.     

Personal warmth and psychological health at midlife

Personal warmth, arguably a strong trait in the makeup of psychological health, seems to fade in conceptual importance at midlife. In contrast, ideas of interiority and androgyny appear to gain conceptual importance at midlife. The present study sought to rebalance these foci by determining the predictive power of personal warmth for psychological health of men and women at age 50: first, by developing separate California Psychological Inventory (CPI) scales to assess personal warmth; next, by joining these warmth scales with the 20 standard CPI scales to predict psychological health. Without the personal warmth scale, the standard CPI scales do not significantly predict psychological health for men; for women, the standard scales do. For both genders, the personal warmth scales add significantly to the predictability of psychological health. The results point to an amendment of current theoretical formulations of interiority and androgyny to better understand optimal psychological development in men and women at midlife.     

Training Psychologists for a Future in Evolving Health Care Delivery Systems: Building a Better Boulder Model

Recent and dramatic changes in the demand for and reimbursement of psychological services and expertise in health care delivery systems have radical implications for the preparation of psychologists at the predoctoral, internship, and postdoctoral levels. In order to respond to these changes effectively and advance the profession, training programs must realize the expanded and potential role of psychological expertise in evolving health care delivery systems. In this paper, we review several limitations and unfortunate consequences of traditional training programs that have confined the scope of research and practice to the realm of mental health. We propose that future psychologists be recognized and trained from a broader perspective as behavioral scientists, prepared to operate at the highest levels of health care delivery systems. Specific recommendations for training and education are discussed.     

Marketing Psychology at Academic Health Centers

The administrative structure of academic health centers is reviewed, with a view to understanding the issues of marketing psychological services within that setting. The slow changes at academic health centers to new practice styles requires psychology to formulate a market strategy addressing the traditional specialist model and another plan responsive to the emerging model emphasizing primary care. Market targets for psychologists include administration, physicians, and patients. Presently, the Association of Medical School Psychologists is working with the Association of Academic Health Centers to design a marketing program targeting leaders at academic health centers.     

形声字心理词典中义符和音符线索的作用

本实验采用启动条件下的词汇判断法,用形声字的义符或音符作为启动刺激,对形声字心理词典中义符和音符线索的作用进行探讨。结果发现：义符线索比音符线索的作用更大;义符、音符对低频字的影响比对高频字的影响更大;当义符、音符与字义、字音一致和不一致时,又符线索和音符线索的作用不一样。     

Effect of response practice variables on learning spelling and sight vocabulary

Four experiments were conducted to examine variables associated with response practice as an instructional technique for individuals with intellectual disabilities. In Experiment 1, the effect of the cover component in the "cover write" method was evaluated, as were the comparative effects of written versus oral practice of spelling words by rehabilitation clients. The results showed that the cover procedure generally did not enhance performance over and above that produced by practice alone, and written practice generally was not superior to oral practice. Experiment 2 demonstrated that less response practice (i.e., five times) was as effective as more practice (i.e., 10 and 15 times) for teaching spelling to adolescents with developmental disabilities. Experiments 3 and 4 also showed that even less response practice (i.e., one time) was as effective as more practice (five times), and irrelevant practice following errors was as effective as relevant practice for teaching spelling and sight vocabulary to adolescents with behavior disorders and developmental disabilities, respectively. The findings suggest that a parsimonious procedure of limited response practice and positive reinforcement may be effective for the tasks and populations studied.     

EVALUATION OF TWO HEALTH EDUCATION STRATEGIES FOR TESTICULAR SELF-EXAMINATION

We evaluated the effects of two health education teaching methods, a pamphlet based on a task-analyzed checklist and two professionally developed films, on the completeness, accuracy, and maintenance of testicular self-examinations (TSE). Subjects (N = 48) were videotaped while performing a TSE after training and at a follow-up visit. Direct observation of the tapes showed that checklist-based training resulted in more complete and longer TSEs (p < .05). Social validation ratings, however, suggested that physicians were unable to discriminate reliably the performances of subjects taught using the two methods. Accuracy of detection of simulated lesions on plastic models was also similar for the two groups. Adherence to TSE recommendations was high during the study, but declined across the follow-up period. Further study is needed to promote adherence to TSE and to document the effects of early detection on morbidity and mortality of testicular cancer.     

复杂性对倾斜汉字识别的影响

以字的复杂性探查汉字心理旋转方式与识别的加工方式,字的复杂性是以笔画数和部件可分性标志的。同时,它们构成两个独立的实验。每个实验中,字的倾斜角度变量,以４５°的间隔渐增,共有８个变式角度,即０°、４５°、９０°、１３５°、１８０°、－４５°、－９０°和－１３５°。实验的因变量为命名反应时。结果发现,字的复杂性标志,无论是笔画数或部件可分性都与倾斜角度变量有交互作用。这意味着,心旋与识别加工方式中的整字－成分的混合模型得到支持。     

卒中部位及局部脑血流量对智力的影响

用长谷川智力测定量表法测定了１８９例卒中患者的智力,分析了病变部位、脑萎缩及局部脑血流量（ｒＣＢＦ）对智力的影响．其中６９例患者长谷川分数低于２１．５分．当病变位于左半球时,属痴呆或可疑痴呆者达４２．９％;而病变位于右半球时,仅２３．１％属痴呆及可疑痴呆．ｒＣＢＦ与长谷川分数之间的相关分析显示：左额、右颞及左顶叶的ｒＣＢＦ与长谷川分数呈极显著正相关．提示左半球在智力活动中起主导作用．脑萎缩亦是影响智力的因素．     

Objective assessments of quality of life: How much do they agree with each other?

Information was collected on 14 objective measures of service quality in 15 staffed houses for people with learning disabilities. Measures or dimensions of the measures were grouped under six headings: (1) quality of housing; (2) social and community integration; (3) social interactions; (4) development; (5) activity; and (6) autonomy and choice. Rank order correlation coefficients were calculated to explore the extent to which different quality assessments within each category agreed. Overall, there was a reassuring level of agreement. Some of the lack of agreement found could be attributed to the fact that, even though addressing the same general area, measures were focused on subtly different facets of the phenomenon under study. Other disagreement seemed to stem from the interaction between the nature of the information and the process for obtaining it. Comparisons between measures which required staff to give an opinion about how the setting was organized, and those which either required staff to comment on resident activity or employed independent observation, tended to disagree. The study illustrates that the basis for translating a multidimensional definition of quality into measurable terms is developing. Further research to examine the interrelationship between measurement approaches is warranted.