The importance of primary care for theoretical medicine: A commentary

Froom and Froom all attention to referral bias as a frequent cause for misinterpreting the medical literature. This is particularly a source of false certainty, and therefore false science, in U.S. practice, where referral centers are often seen as the only legitimate source of medical knowledge and where primary care is discounted as a source of scientific observations. Appreciation of the primary care setting is therefore a critical element in theoretical understanding of medical epistemology.     

MANAGEMENT OF INAPPROPRIATE BEHAVIORS OF TRAINABLE MENTALLY IMPAIRED STUDENTS USING ANTECEDENT EXERCISE

The effects of several levels of exercise on inappropriate behaviors of four trainable mentally impaired students were observed. Treatment conditions, which occurred as the first daily activity, included: Phase I, daily alternating conditions of warm-up exercises and jogging at a moderate rate for a short distance; Phase II, daily alternating conditions of no-exercise periods and jogging at a vigorous rate for a moderate distance; and Phase III, jogging at a vigorous rate for a moderate distance on consecutive days. For one student two additional conditions occurred, Phase IV, long-distance jogging on consecutive days at a vigorous rate and Phase V, consecutive days of no exercise. Observations of three inappropriate behaviors of each student occurred immediately after, 1 hour after, and 2 hours after each exercise period. Results indicate a decrease in all three inappropriate behaviors for three of four students and an inverse relationship between the level of exercise and the amount of inappropriate behavior for three of four students. Improvements over existing studies are discussed with suggestions for future research.     

Mirrors, Clocks, Maps, and Music: A South African Response to Family Therapy Supervision/Training

Once upon a time a training unit embarked upon a Journey. The Journey was to encompass a year's training and supervision in family therapy. Bags were packed to the brim with theory and training methods. One day the Unit left the bags behind to see what would happen if they travelled light and let the students bring their own luggage to the examination. Students were expected to describe their relationships with the interviewed families, and their training through a story. The great exam day came. Inspired students used innovative ideas and metaphors to describe the Journey. This article tells the story about these stories and the Unit's learning from them.     

山东沿海地区大学生日常时间用语词义赋值的研究

本研究运用模糊统计试验的方法对五组日常时间用语词进行了经验赋值 ,被试是 3 1 2名大学生。结果表明 :(1 )被试对日常时间用语词词义的理解是模糊的 ,其赋值指向较大的区间 ;(2 )被试对日常时间用语词的赋值受词自身具有的数值的影响 ,受词的下属时间单位数量的影响 ;(3 )词义相近的词赋值亦接近 ;(4)对表示人的年龄的词的赋值因对象的性别、词的熟悉性和赋值区间的封闭性的不同而不同 ;(5 )“几”在表示时间的数量时对应的赋值区间是3～ 5     

Are General Practitioners Willing and Able to Provide Genetic Services for Common Diseases?

Primary care in the United Kingdom has been advocated as an optimal location for the provision of genetic services for common diseases. Little, however, is known about general practitioners' own views toward this suggestion or the possible demand for such services from patients. To assess general practitioners' attitudes to providing genetic services for common diseases, and to estimate the demand from patients for these services, we used a single-page postal questionnaire survey of all 359 general practitioners registered with the Oxfordshire Health Authority; 339 (94%) responded. These physicians reported that a mean 4.1 patients (95% CI, 3.3–4.9) out of every 1,000 consulting them were concerned about their own risk of a common disease associated with a diagnosis in a family member. Half of the general practitioners (95% CI, 45–56%) counseled about genetics in the last year. A majority of general practitioners accept the need to provide genetic services, but far fewer are competent to do so. Although 60% (95% CI, 55–65%) believed they should be involved with genetic screening for common diseases, only 29% (95% CI, 24–34%) felt sufficiently prepared to take family histories and draw pedigrees, and only 15% (95% CI, 11–19%) felt sufficiently prepared to counsel patients about their genetic test results. Given the necessary training and information, 63% (95% CI, 58–68%) and 64% (95% CI, 59–69%) were willing to provide these services. Even with training and information, not all would be willing to provide these services, and lack of time may be a major deterrent. Practice-enabling strategies, such as computerized aids in genetics, may be useful.     

An analysis and replication of the Add-A-Word Spelling Program with mildly handicapped middle school students

The effects of the Add-A-Word Spelling Program was examined in two experiments with mildly handicapped middle school students. In Experiment I, the Add-A-Word program with daily testing of small word lists; drill through the copy, cover, and compare method; a high level of mastery before words were removed from the student's list; and reappearance of mastered words, was evaluated with a multiple baseline design across three students. The data indicated improved performance on daily spelling tests when the Add-A-Word system was implemented. The purpose of Experiment II was to compare the Add-A-Word spelling program to the more traditional Monday Pre- and end of the week Posttest spelling procedures found in most classrooms. The comparisons were made in a counterbalanced multiple baseline design across six students. The students' overall accuracy in spelling was higher during the Add-A-Word Program than during either Baseline (daily testing) or the Preand Posttest systems. However, student's spelling scores were also higher during the Pre-Posttest procedure than during the Baseline condition. Benefits of the Add-A-Word spelling program for middle school students were discussed.     

Effects of implementing a token economy on teacher attending behavior

After systematic attempts to increase a teacher's positive responding to her first-grade students, a token-economy system was implemented as a "last resort". On-task student behavior and relative frequency of positive and negative teacher comments were systematically observed. Data indicated that institution of the token system was associated with a relatively higher percentage of positive than negative comments. Termination and re-implementation of the token system caused reversals of the teacher's behavior.     

PROCEDURES TO INCREASE SOME ASPECTS OF CREATIVITY

Instructions, reinforcement (team points), and practice were applied to four behaviorally defined creative behaviors of eight fourth- and fifth-grade students. All four aspects (number of different responses, fluency; number of verb forms, flexibility; number of words per response, elaboration; and statistical infrequency of response forms, originality) were demonstrated to be under experimental control. The procedures also raised students' scores on Torrance's tests of creativity. Application of the experimental procedures may well be practical for classroom teachers.     

STIMULUS CONTROL IN THE CLASSROOM AS A FUNCTION OF THE BEHAVIOR REINFORCED

Eight fifth- and sixth-grade children with behavior problems performed in a classroom under three conditions: (1) unreinforced baseline, (2) reinforcement for being on task, and (3) reinforcement for the accuracy and rate of math problems solved. The teacher was absent for a portion of the class session under each of these conditions. In the teacher's absence, on-task behavior declined markedly and disruption markedly increased, regardless of the reinforcement condition in operation. In addition, the teacher's absence resulted in fewer problems attempted and decreased accuracy. However, the extent to which the children became disruptive was reduced and the number of problems attempted increased when reinforcement was contingent on academic accuracy and rate, instead of being contingent on being on task. The results suggest that by providing contingencies for the products of a child's classroom activities, rather than for being on task, the child will become more independent of the teacher's presence, and more under the control of the academic materials.