Effects of Self-Correction on the Acquisition, Maintenance, and Generalization of the Written Spelling of Elementary School Children

We examined the effect of self-correction on the acquisition, maintenance, and generalization of written spelling of elementary school students attending an after-school clinic. Six students registered for remedial tutoring participated. During self-correction, students initially learned four proofreading marks and a procedure for using them that were subsequently applied as the students compared their spelling to a model. Results showed a functional effect between self-correction and improved student performance on target words. Using the self-correction procedure, the students spelled at least 98% of the target words accurately, maintained at least 85% of the correctly spelled words, and generalized at least 70% of the words at home, in context, and with word variations. Questionnaires administered to the students, their parents, and teachers indicated that students preferred self-correction. Parents noticed academic improvements in their child's spelling performance as well as positive changes in attitude toward school. Most teachers did not notice changes in spelling performance or attitude.     

Fallacies and moral dilemmas

The continuing debate between utilitarians and deontologists often takes the form of disagreement over how particular moral dilemmas are to be resolved, but protagonists on both sides tend to overlook the possibility of resolving a dilemma with remainder, such as regret. The importance of remainder is also overlooked by critics of some absolutist ways of resolving or slipping between the horns of certain moral dilemmas. Moreover, deontologists, if not utilitarians, can be criticised for overlooking the possibility that, according to their theory, some dilemmas may be irresolvable. Virtue ethics, with its concentration on the agent, readily accommodates both mention of remainder and irresolvable dilemmas, and yields a specification of tragic dilemmas which the other two theories might like to take on.     

Reflections on segregating and assessing areas of competence

Various complexities that arise in the application of legal and/or clinical criteria to the actual assessment of competence/capacity are discussed, and a particular way of understanding the nature of such criteria is recommended.     

Effects of diagnostic classification systems on clinical hypothesis-generation

In this study it was determined whether (a) classification as opposed to absence of classification has an effect on the quality of clinical hypotheses (b) the DSM-III-R and the CBCL have a different effect on the quality of clinical hypotheses, and (c) the potential difference between the DSM-III-R and the CBCL is moderated by the different number of syndromes identified by these systems. To investigate these questions, an experiment was conducted in which 86 clinicians generated hypotheses for six cases. The clinicians were divided into a DSM-III-R, a CBCL, and a control group. Of the six cases, two were classified by both classification systems as one syndrome, two were classified as one syndrome by the DSM-III-R but as two syndromes by the CBCL, and two were classified as two syndromes by the DSM-III-R but as one syndrome by the CBCL. The quality of the hypotheses was determined by means of four dependent variables selected from an overview of qualitative criteria: explanatory value, redundancy, possibility of operationalization, and specificity. No differences between the CBCL and the control groups were found. The DSM group performed better than the control group regarding explanatory value and redundancy. The DSM-III-R group also scored better than the CBCL group regarding explanatory value, particularly when the number of identified syndromes was two for the CBCL and one for the DSM-III-R.     

Competing interests: The need to control conflict of interests in biomedical research

Individual and institutional conflict of interests in biomedical research have becomes matters of increasing concern in recent years. In the United States, the growth in relationships — sponsored research agreements, consultancies, memberships on boards, licensing agreements, and equity ownership — between for-profit corporations and research universities and their scientists has made the problem of conflicts, particularly financial conflicts, more acute. Conflicts can interfere with or compromise important principles and obligations of researchers and their institutions, e.g., adherence to accepted research norms, duty of care to patients, and open exchange of information. Disclosure is a key component of a successful conflict policy. Commitments which conflict with a faculty member's primary obligations to teaching, research, administrative responsibilities, or patient care also need attention. Institutional conflict of interests present different problems, some of which are discussed in an analysis of an actual problem posed by two proposed clinical trials. This paper is adapted from a lecture presented to a Symposium on Scientific Integrity, Warsaw, Poland, 23 November 1995. Daniel Steiner was Vice-President and General Counsel of Harvard University (1972–92) and in that capacity became familiar with conflict of interest issues. He is currently Counsel to the Boston law firm. Ropes and Gray, and is Adjunct Lecturer in Public Policy at the John F. Kennedy School of Government. Harvard University.     

A biopsychosocial therapeutic approach in a private outpatient clinic in Portugal

Patients with chronic stress and ambiguous symptoms are likely to be more frequent in primary care. Somatizers represent 75.8% of the patients in this study and executives 56% of the sample. Job stressors were present in 78.3% of executive men. This scenario suggests that the primary care physician has to be academically better prepared to fully understand and deal with stress problems in daily clinical practice. The physician must have skills to deal with stress at a curative and preventive level, extending those skills to the workplace.     

Do medical decision analyses' largest gains grow from the smallest trees?

Some decision analysts recommend reserving their models for careful, complete study of complex problems. Others believe simple problem analyses provide the greatest gains. To clarify these issues, I tested: (1) whether simple published analyses compared to complex ones, produced results as non-intuitive; and (2) whether non-intuitiveness represented analytic gain (or equivalently, intuitive loss). Very limited data also examined (3) the gain from adding model intricacy for a given problem vs. selecting more complex problems for analysis. To assess two non-intuitiveness measures, 75 subjects (33 physicians and 42) non-physicians stated their intuitive preferences in 40 (22 published and 18 unpublished) medical dilemmas. For both physicians and non-physicians, simpler models (those with lees than 30 terminal branches in the decision tree) had about one third the non-intuitiveness of more complex ones. Three tests also supported the premise that analyses outperform intuition, therefore that on average the formers' non-intuitiveness reflects less analytic gain. In addition, for different models of the same problem, tree complexity did not correlate with gain. Thus, simpler trees may not generally gain less because they inadequately describe problems. Instead, simpler analyses may represent simpler problems, with more similar intuitive and formal solutions. If so, these findings may help us avoid some costly but unnecessary simple analyses.     

THE FUNCTIONS OF ASSESSMENT: IMPLICATIONS FOR SELECTION AND DEVELOPMENT OF DEVICES FOR ASSESSING REPERTOIRES IN CLINICAL,EDUCATIONAL, AND OTHER SETTINGS

An attempt is made to identify the many different functions that assessment of an individual's repertoire can serve. Implications of these functions for the character of and evidence about assessment devices are suggested. The functions fall into two general groups, those which influence decisions regarding an individual learner, and those which influence policy, program development, and scientific knowledge. The first group of functions is presented in a rough chronological sequence such that they form a “behavioral assessment funnel,” beginning with functions involving broad-band assessment to identify likely persons and skill areas, and narrowing to the precise pinpointing, monitoring, and follow-up functions. The contribution of behavior analysis and behavior therapy to assessment methodology in this sequence is identified as well as the areas where more traditionally conceived methods are still useful. The second group of functions and behavioral contributions to it are then discussed.     

国内外医学专业杂志发表医学人文相关文章情况分析

总结分析了201 2年1月～2013年5月国外4种医学专业杂志(BMJ、JAMA、LANCET和NEJM)医学人文相关文章的发表情况,并与国内4种知名医学专业杂志(《中华医学杂志》、《中国实用内科杂志》、《中华内科杂志》和《中华外科杂志》)发表的医学人文类文章的情况进行对比分析,结果发现,国外医学专业杂志医学人文类文章比重较大,而且涉及的领域较广,包括医疗卫生政策管理、医学社会学、对患者及医生的人文关怀、医疗风险告知和医疗差错告知的文章.而国内与国外杂志相比存在较大差距.