Choice of medical specialty: analysis of students' needs.

The purposes of this study were to assess the career development needs of entering medical students as measured by the Medical Career Development Inventory and to examine gender differences in responses to the inventory. A total of 115 entering medical students (representing two entering classes) took the inventory two months prior to matriculation. Analysis suggested that this sample of entering students had formed a vocational identity and that they had evaluated the suitability and viability of a commitment to a physician's career. However, the participants had not formed a clear picture of their specialty interest and goals. No significant gender differences were indicated. A recommended career assistance workshop is presented as appropriate for these students' needs.     

The role of syllabic and orthographic properties of letter cues in solving word fragments

The present research examined the role of phonological and orthographic properties of cues in mediating the retrieval of words from the mental lexicon. The task required subjects to resolve fragmented words when provided with semantically related cues (e.g., spiteful:---DIC----). Phonological properties of the letter cues were manipulated such that the letters either corresponded to the syllables (e.g., DIC in vindictive) or nonsyllables (NDI) in the word. Orthographic properties of the letter cues were manipulated by selecting letter groups that either co-occurred frequently in the language or did not. In two experiments, results revealed little or no effect of the phonological variable (syllables) but a reliable effect of the orthographic variable (letter-cue frequency). Letter cues with a low frequency of co-occurrence in the language led to better completion of the fragmented words. We interpret these findings as support for models of lexical representation that are based on orthographic properties (e.g., Seidenberg & McClelland, 1989) rather than those based on phonological constraints.     

Single and combined effects of methylphenidate and behavior therapy on the classroom performance of children with attention-deficit hyperactivity disorder

Twenty-four boys with attention deficit-hyperactivity disorder (ADHD) participating in an intensive summer treatment program each received b.i.d. placebo and two doses of methylphenidate (MPH, 0.3 mg/kg and 0.6 mg/kg) crossed with two classroom settings: a behavior modification classroom including a token economy system, time out and daily home report card, and a regular classroom setting not using these procedures. Dependent variables included classroom observations of on-task and disruptive behavior, academic work completion and accuracy, and daily self-ratings of performance. Both MPH and behavior modification alone significantly improved children's classroom behavior, but only MPH improved children's academic productivity and accuracy. Singly, behavior therapy and 0.3 mg/kg PMH produced roughly equivalent improvements in classroom behavior. Further, the combination of behavior therapy and 0.3 mg/kg MPH resulted in maximal behavioral improvements, which were nearly identical to those obtained with 0.6 mg/kg MPH alone.The authors gratefully acknowledge the assistance of Patricia Donovan, Michelle Berry, Mary Ingram, Patricia Wells, Beth Gnagy, Karen Greenslade, Mary Hamilton, and the entire staff of the Western Psychiatric Institute and Clinic ADHD Summer Treatment Program.     

Clinical ethics consultations: reasons for optimism, but problems exist

[The author identifies] five problems familiar to clinical ethicists. (1) Physicians often do not recognize important ethical issues. (2) Debate exists over whether such consultations should give specific management recommendations. (3) Principles of medical ethics cannot, by themselves, resolve real ethical issues. (4) The patient's interests sometimes conflict with the interests of the family, the health professionals, and the hospital. (5) Clinical ethics consultations take a toll on the consultant....[He] discuss[es] the implications of each problem for clinical ethics consultations and offer[s] a solution to it.