The elderly and high technology medicine: A case for individualized,autonomous allocation

The issues involved in decision making about the aggressiveness of future medical care for older persons are explored. They are related to population trends, the heterogeneity of older persons and a variety of factors involved in individual preferences. Case studies are presented to illustrate these points, as well as a review of pertinent literature. The argument is offered that, considering these many factors, a system of flexible, individualized care by informed patient preference, is more rational than the rationing of technological services by age.     

The expected likelihood of transitivity of preference

May's model of pairwise preference determination is used to assess the expected likelihood that a subject's pairwise preference comparisons on three alternatives will be transitive. A closed form representation for this expected likelihood is obtained for each situation considered. When the subject is assumed to act precisely according to rankings on attributes with May's model, the computed expected likelihoods the relatively large. When the subject becomes a probabilistic chooser, as defined in a specific manner, expected likelihoods of transitivity decrease significantly from corresponding values with May's model. For a probabilistic Chooser, there is a significant likelihood that the subject might yield transitive pairwise preferences substantially different than the results suggested by May's model.This research was supported by a grant from the General University Research Program and through a fellowship from the Center for Advanced Study, both of the University of Delaware. Very helpful input from John H. Antil, Meryl P. Gardner, and James M. Munch is also acknowledged.     

EMERGENCE OF REINFORCER PREFERENCE AS A FUNCTION OF SCHEDULE REQUIREMENTS AND STIMULUS SIMILARITY

Tustin (1994) recently observed that an individual's preference for one of two concurrently available reinforcers under low schedule requirements (concurrent fixed-ratio [FR] 1) switched to the other reinforcer when the schedule requirements were high (concurrent FR 10). We extended this line of research by examining preference for similar and dissimilar reinforcers (i.e., those affecting the same sensory modality and those affecting different sensory modalities). Two individuals with developmental disabilities were exposed to an arrangement in which pressing two different panels produced two different reinforcers according to progressively increasing, concurrent-ratio schedules. When two dissimilar stimuli were concurrently available (food and a leisure item), no clear preference for one item over the other was observed, regardless of the FR schedules in effect (FR 1, 2, 5, 10, and 20). By contrast, when two similar stimuli were concurrently available (two food items), a clear preference for one item emerged as the schedule requirements were increased from FR 1 to FR 5 or FR 10. These results are discussed in terms of implications for conducting preference assessments and for selecting reinforcers to be used under training conditions in which response requirements are relatively high or effortful.     

THE EFFECTS OF CHOICE AND TASK PREFERENCE ON THE WORK PERFORMANCE OF ADULTS WITH SEVERE DISABILITIES

We evaluated the effects of choice versus the assignment of tasks of varying preferences on the work engagement of adults with severe disabilities. The combined results of two experiments suggest that the relative preference for a task may be an important variable in the effectiveness of choice for some individuals.     

汉字内隐记忆的实验研究（Ⅱ）：任务分离和反应倾向

在实验Ｉ的基础上,操纵学习时的呈现时间（２５０ｍｓ,５００ｍｓ,７５０ｍｓ）和注意变量（目标和非目标字）,运用任务分离方法及间接证明逻辑,比较了再认测验和整字偏好测验在不同条件下的辨别力（Ａ′）和反应倾向（Ｂ″）。结果：（１）双向功能分离的出现表明再认测验和偏好测验存在本质差异。根据“过程纯净”假设,可以推证内隐记忆存在于偏好测验中。此时,匹配比较法的标准未满足。（２）偏好测验中,５００ｍｓ呈现目标字时,有显著正向启动效应：７５０ｍｓ呈现非目标字时,有显著负向启动效应。（３）内隐记忆和外显记忆发生时,都具有稳定的心理状态。但是前者的报告标准较松宽,而后者的较严格。     

A PRELIMINARY PROCEDURE FOR PREDICTING THE POSITIVE AND NEGATIVE EFFECTS OF REINFORCEMENT-BASED PROCEDURES

In the current investigation, a modification was made to the preference assessment described by Pace, Ivancic, Edwards, Iwata, and Page (1985) to predict the effects of stimuli when used in a differential-reinforcement-of-other-behavior (DRO) schedule for 2 clients with severe self-injurious behavior (SIB) and profound mental retardation. Based on the results of the preference assessment, three types of stimuli were identified: (a) high-preference stimuli associated with high rates of SIB (HP/HS), (b) high-preference stimuli associated with relatively lower rates of SIB (HP/LS), and (c) low-preference stimuli associated with low rates of SIB (LP/LS). Consistent with the results of the preference assessment, the DRO schedule with HP/HS stimuli resulted in increased SIB, and the DRO schedule with LP/LS stimuli resulted in no changes in SIB. HP/LS stimuli were demonstrated reinforcers but did not result in a change in SIB when used in a DRO schedule. Thus, the stimulus preference assessment may be useful clinically in some situations for predicting both the beneficial and the negative side effects of stimuli in DRO procedures.     

Local contrast and maintained generalization.

Pigeons received variable-interval reinforcement for key pecking during presentations of horizontal and vertical line-orientation stimuli, while pecks during five intermediate orientations were extinguished. Lowest peck rates were observed during presentations of negative stimuli adjacent to the positive orientations while peck rate during 45 degrees (the intermediate negative orientation) was relatively high, i.e., there were negative contrast shoulders. When peck rates were manipulated in the positive orientations, peck rate in neithboring orientations changed in the opposite direction. Contrast shoulders faded after prolonged training. A second type of contrast, local contrast, was correlated with similarity of preceding stimulus and different average peck rates during different stages of the discrimination process. The data suggest that sequential local contrast accompanying the formation of a discrimination contributes to the form of generalization gradients. Blough's model of stimulus control predicts the changes in gradient form described here, but may not accurately depict the underlying process responsible for gradient form.     

Multivariate stochastic processes compatible with “aspect” models of similarity and choice

Various recent works have developed feature or aspect models of similarity and preference. These models are more concerned with the fine detail of the judgment process than were prior models, but nevertheless they have not in general developed an underlying stochastic process compatible with the assumed structure. In this paper, we show that a particular class of multivariate stochastic processes, namely those associated with the Marshall-Olkin multivariate exponential distribution, generates several of these models. In particular, such stochastic processes (appropriately interpreted) yield Tversky's elimination by aspects model, Edgell and Geisler's (normal) additive random aspects model, and Shepard and Arabie's additive cluster model.This work was supported by Natural Science and Engineering Research Council of Canada Grant A8124 to A.A.J. Marley.