Prevention of nonadherence to nonsteroidal anti-inflammatory medications for newly diagnosed patients with juvenile rheumatoid arthritis.

Adherence to medications for chronic pediatric diseases decreases overtime. This randomized controlled trial evaluated a clinic-based, nurse-administered educational and behavioral intervention to prevent the anticipated drop in adherence to nonsteroidal medications among newly diagnosed patients with juvenile rheumatoid arthritis. Thirty-four participants completed the study (mean age = 8.44 years, SD = 3.96), including 19 in the experimental group and 15 in the standard-treatment (education) control group. There were significant group and Group x Time effects for adherence (assessed with an electronic monitor over a 13-month period) favoring the experimental group. In contrast, the groups did not differ significantly in disease activity or functional limitations. Factors that may have prevented detection of differences in these health parameters are dicussed.     

The Heart of the Matter: An Essay about the Effects of Managed Care on Family Therapy with Children*

This essay is based on a pilot study that examined the effects of managed care on the treatment of children and families, with special attention to community mental health. We embarked on the pilot study to test the accuracy and generalizability of our impression that family therapy and other systemic practices have been marginalized in ordinary clinics and agencies, and to understand the reasons why. We interviewed managed care providers, researchers, family therapy trainers, and clinicians in the Northeast. Our findings led to seven themes that support our impression that, even though there is a consensus about the need for coordinated family-based services, there is a disconnection between state policies, contractual requirements and what is actually occurring at the implementation level. This study suggests that our knowledge of human systems may be in danger of being disqualified and lost, with damaging consequences for the care of children. Yet, as systemic thinkers and practitioners, it is our belief that ethical and effective treatment need not be at odds with care that is cost-efficient. The direction of our future research will be to study whether the involvement of all stakeholders at all levels of planning and training leads to systemic family-based practices that consistently save costs and provide high-quality care.     

Bias in the use of base rates: Racial prejudice in decision-making

Two studies investigated biases in the use of base rate information when assessing the probability of a witness' accurate identification of a white or West Indian as a burglar. An adapted version of the Kahneman-Tversky cab problem was used, to provide a social decision in which biases could be measured against some normative standard. Ethnicity of youth (white/West Indian) and nature of base rate (incidental/causal) were manipulated in a 2 × 2 between-subjects design. A significant interaction effect revealed that subjects took no account of the base rate for a West Indian subject, but used the base rate only when it was causal and the youth was white. This ‘prejudice effect’ against a West Indian youth and ‘exoneration effect’ for a white youth were replicated in a second study, using a microcomputer and chronometric analyses. Results are discussed in terms of heuristic decision-making, social schemata, and the cognitive versus motivational bases of bias in the use of base rates.     

Insight-oriented group psychotherapy of latency-age children in an acute care setting

Traditional approaches to group therapy with latency-age children have stressed activity and nonverbal therapeutic interventions. These approaches originated in the 1940s with Slavson's activity aroup therapy. A review of the literature of the past 25 years reveals that many clinicians have increasingly employed verbal techniques with latencyage groups. Most such reports describe groups for latency-age out-patients. In this paper, a verbal, interpretive technique for group therapy with latency-age inpatients is described. Clinical vignettes are included to illustrate this technique. Our experience suggests that such a technique can become an integral part of the inpatient treatment program for the latency-age child.     

On the Relation Between Time Perception and the Timing of Motor Action: Evidence for a Temporal Oscillator Controlling the Timing of Movement

Studies of time estimation have provided evidence that human time perception is determined by an internal clock containing a temporal oscillator and have also provided estimates of the frequency of this oscillator (Treisman, Faulkner, Naish, & Brogan, 1992; Treisman & Brogan, 1992). These estimates were based on the observation that when the intervals to be estimated are accompanied by auditory clicks that recur at certain critical rates, perturbations in time estimation occur. To test the hypothesis that the mechanisms that underlie the perception of time and those that control the timing of motor performance are similar, analogous experiments were performed on motor timing, with the object of seeing whether evidence for a clock would be obtained and if so whether its properties resemble those of the time perception clock. The prediction was made that perturbations in motor timing would be seen at the same or similar critical auditory click rates. The experiments examined choice reaction time and typing. The results support the hypothesis that a temporal oscillator paces motor performance and that this oscillator is similar to the oscillator underlying time perception. They also provide an estimate of the characteristic frequency of the oscillator.     

A note on russell's paradox in locally cartesian closed categories

Working in the fragment of Martin-Löfs extensional type theory [12] which has products (but not sums) of dependent types, we consider two additional assumptions: firstly, that there are (strong) equality types; and secondly, that there is a type which is universal in the sense that terms of that type name all types, up to isomorphism. For such a type theory, we give a version of Russell's paradox showing that each type possesses a closed term and (hence) that all terms of each type are provably equal. We consider the kind of category theoretic structure which corresponds to this kind of type theory and obtain a categorical version of the paradox. A special case of this result is the degeneracy of a locally cartesian closed category with a morphism which is generic in the sense that every other morphism in the category can be obtained from it via pullback.The financial support of the Royal Society in London is gratefully acknowledged.