AIDS: the statistical basis for public health

Inhibition of the Na-Ca exchange at the beginning of rest in isolated myocytes of the guinea-pig heart by means of superfusion with Na,Ca-free solution or 5.0 mM Ni2+ resulted in appearance of multiple phasic contractures. Contractures could not be initiated when the sarcoplasmic reticulum (SR) Ca2+ had been depleted by short (1 s) or steady state exposure to 10 mM caffeine, 0.1 microM ryanodine or due to rapid spontaneous release of the SR Ca2+ occurring sometimes at the beginning of rest. Superfusion with 2 x 10(-7) M thapsigargin, which blocked the SR Ca2+ uptake, prevented contractures otherwise initiated by superfusion with the Na,Ca-free solution. The frequency of spontaneous contractures was positively related to the rate of stimulation before rest and negatively related to the duration of rest before superfusion with the Na,Ca-free solution. It is proposed that in guinea-pig myocardium Ca2+ taken up by the SR from sarcoplasm or other cellular compartments like mitochondria, is released during diastole and rest to the subsarcolemmal space from which it is extruded by means of Na-Ca exchange. The release is a primary event not dependent on decrease of the resting sarcoplasmic free [Ca2+] by the outward Ca2+ transport. Inhibition of the Na-Ca exchange at the beginning of rest did not initiate any contractile response in rat myocytes. If the spontaneous contractures were already present, they were inhibited by superfusion with the Na,Ca-free solution. The result reflects the basic difference in the properties of SR of guinea-pig and rat.     

The efficacy of psychotherapy as the basis for public policy.

Discusses the tremendous growth that has occurred in the number of mental health providers, the rate of use of mental health services, and public and private reimbursement for mental health care. Governmental policymakers and leading insurance officials continue to seek information regarding the appropriateness and efficacy of specific psychotherapeutic techniques with various types of presenting problems. The efforts during the Carter administration to stimulate additional efficacy research and knowledge synthesis regarding the efficacy of psychotherapy are described. A public policy proposal is forwarded that no form of health intervention—physical or mental—should be supported through 3rd-party reimbursement and publicly supported training programs unless it has been demonstrated to be safe and effective. It is argued that randomized controlled clinical trials should be viewed as the most valid, though not exclusive, source of evidence. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Presentation: Epidemiology and public health: is a new paradigm needed or a new ethic?

Bone sialoprotein (BSP) is a small, highly posttranslationally modified integrin binding protein found in the mineral compartment of developing bone. The recent discovery that BSP can be detected in a variety of human cancers, particularly those that metastasize preferentially to the skeleton, shed light on potential new biological functions for this protein. The demonstration of a positive association between BSP expression in primary breast tumors and the development of bone metastases suggests that this glycoprotein could play a role in the selective implantation of breast cancer cells in bone. BSP is also expressed in most lung and prostate cancers as well as in multiple myeloma, three other osteotropic malignancies. Because thyroid carcinoma also metastasizes preferentially to the skeleton, we decided to look at the expression of BSP in a collection of 145 thyroid malignant lesions including 24 follicular thyroid carcinomas (FTCs), 55 papillary thyroid carcinomas (PTCs), 19 medullary thyroid carcinomas (MTCs), 23 anaplastic carcinomas (ACs), and 24 poorly differentiated carcinomas (PDCs). BSP expression was evaluated by immunoperoxidase technique using two specific polyclonal antibodies. Most of the thyroid carcinomas (72%) examined expressed high levels of BSP. Expression of BSP was significantly lower in FTCs and MTCs compared with PDCs, which are more aggressive (p = 0.0009 and 0.0003, respectively). Our study demonstrates for the first time that ectopic BSP expression is a common feature of thyroid cancer. The prognostic value of BSP detection in thyroid adenocarcinoma and the potential role of BSP in the propension of this type of cancer to metastasize to bone are currently under investigation.     

The social psychological basis for public acceptance of the social security system: The role for social research in public policy formation.

Examined the issue of carrying out research that meets traditional standards of quality while bearing upon significant public issues. Measures of orientation toward socal security were studied, using an opinion questionnaire administered in 615 home interviews in 3 cities. Results indicate that people are committed to social security because it is work-connected through the payroll tax. There is no dissatisfaction with the system by persons who appear to bear the brunt of its inequities. Factors related to willingness to pay into the system are noted. The question of why there has been no previous social psychological research on the social security program is considered, and ways of coping with this lack are suggested. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The mediational model and shift behaviour in a complex concept-attainment paradigm.

Employed a complex stimulus situation in a variation of the reversal-nonreversal paradigm. 40 adult male Ss were given part and whole reversal and nonreversal shifts to perform on a 4-dimensional, 2 relevant dimension concept-attainment paradigm. It was found that the usual superiority of the reversal shift held only for part shifts; for whole shifts the nonreversal shift was more readily performed. Results are incompatible with the 2-stage mediational approach as currently formulated, and a tentative explanation in terms of hypothesis-testing strategies is outlined. A replication incorporating a control for E bias verified the original results. (French summary) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

公共政策制定中的公众参与问题

随着社会的发展、民主进程的推进,人民的权利意识日益觉醒,其参政议政的热情日益高涨,但现实生活中却存在着种种制约公众参与度提高的因素,本文试看从公众参与度不高的原因分析入手,在介绍其必要性之后提出一些改进意见,以期能时现实中存在的问题有所帮助.     

Complex behavior or higher mental process: Is there a paradigm shift?

Analysis of the basic nature of scientific paradigms during periods of stability and change indicates that no particular set of properties of a scientific viewpoint determines a paradigm. After World War II, major formal and theoretical advances outside psychology gradually gave rise to procedures and ideas applicable to formulations in competition with the behavioristic approaches. Problems within stimulus-response behaviorism which were generally conceived to be empirically resolvable also proved to be intractable. It is concluded that neobehavioristic positions have weakened considerably in the face of competition and that the justification for the domination of psychology by neobehaviorism has eroded. (53 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Either a paradigm shift or no mental measurement: the nonscience and the nonsense of The Bell Curve

We have shown previously that intravenous infusions of insulin, known to induce glucoprivic hunger, and of insulin combined with glucose, known to induce satiety, produce in the VMH and PVN of Wistar rats monoaminergic changes that differ from those related to spontaneously occurring hunger and satiety, while the genetically obese Zucker rat is totally resistant to the behavioural effects of insulin and insulin + glucose infusions. In the present study, the impact of these infusions on VMH and PVN monoamines in obese Zucker rats was assessed using microdialysis. Monaminergic changes (increase in DOPAC and 5-HIAA and decrease in DA and 5-HT) were quite similar in obese rats to those we found in normal rats when insulin was infused. In contrast, changes in 5-HT or DA in response to insulin and glucose were quite different in the Zucker rat. Monoaminergic changes related to meals were more dramatic in the Zucker rat and so were able to reverse the background changes produced by the insulin infusion. These data confirm the idea that the effect on monoamines of spontaneously occurring hunger and satiety is different from the effect on monoamines by insulin and glucose-induced hunger and satiety. The results show disturbances of the obese Zucker rat related both to insulin and to hypothalamic monoamines that may be involved in the hyperphagia and obesity of this model.     

Health psychology and public policy: The political process.

During the past 20 years, psychologists have successfully modified federal statutes, resulting in recognition of the profession's clinical and research expertise. Despite these successes, professional psychology's training institutions have largely failed to address basic issues in health policy and the implications of national health policy for psychology. The importance of public health programs under Title VII of the Public Health Act and the significance of full inclusion of psychology in all federal health programs, including Titles XVIII (Medicare) and XIX (Medicaid), are poorly understood by most health psychologists. Federal health policy decisions, including management of excessive federal health spending, will dictate the growth and opportunities for health psychologists. Understanding federal health spending and recent federal initiatives such as Resource Based Relative Value Scale, Diagnostic Related Groups, and practice guidelines will be of benefit to health psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child health in America: toward a rational public policy

Analysis of currently available data on mortality and morbidity indicates that the major organic illnesses of childhood, and their developmental consequences, are susceptible in part to the technical interventions of American medical science. Environmental forces, however, exert a powerful impact on the health of children in the United states, manifested both in the disproportionate toll of most organic diseases on poor and nonwhite populations and in such increasingly important symptoms of familial, social, and behavioral distress as child abuse, accidents, and childhood suicide. Review of the nature, quality, and distribution of child health services demonstrates a systemic inability to reach and treat the children most in need of them. A rational basis for child health policy includes: appropriate concepts of health, disease, and preventive and therapeutic intervention; a capacity to acknowledge, to measure, and to act on the familial and environmental, as well as the medical, sources of illness; an orientation to the developmental and social implications of good and poor child health; and a commitment to enable all children to receive health services. The data and this policy framework lead to these program recommendations: the channeling of resources into a more rational system which guarantees equity and access; a planning and program implementation mechanism which addresses the health needs of diverse local populations and which makes real the advocacy concept; a screening, evaluation, and surveillance methodology; a delivery system which both applies preventive and curative health technology and addresses basic life needs of children; and a coherent program for the training, assignment, and supervision of the several kinds of manpower which such a system would require.     

The liberating effect on the analyst of the paradigm shift in psychoanalysis.

Discusses a paradigm shift in psychoanalysis. This new paradigm is reflected in dyadic systems perspective, relational theorizing, social constructivism, and intersubjectivity theory. The author illustrates the shift's impact upon psychoanalysis with the effects of intersubjectivity theory upon his own practice. From the intersubjective perspective, there are (1) few metapsychological assumptions, (2) no assumptions of core universal conflicts, (3) a liberation of the analyst's feelings in ways that facilitate therapy, (4) a susceptibility to different errors than those of other theories, and (5) a nonadversarial approach to resistance. These 5 ideas are elaborated and illuminated by a selective use of the literature and clinical vignettes. Finally, a personal addendum describes the author's painful conflict in moving from a traditional to a constructivist stance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Complex behavior or higher mental process: Is there a paradigm shift?" Comment.

Criticizes E. M. Segal and R. Lachman's (see record 1972-22033-001) usage of the concept of paradigm, which bears little relation to Kuhn's conception. The author also comments on ethnocentrism in Segal and Lachmen's work and in American psychology, and suggests that if this ethnocentrism masking the continuous multiparadigm nature of psychology were eliminated, psychologists could approach serious questions about the operation of schools or communities in preparadigmatic science. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tobacco psychopharmacology and public health policy: It takes a community.

This commentary is based upon the author's lecture given as the 2010 recipient of the award named in honor of Drs. Joseph V. Brady and Charles R. Schuster, given by the Psychopharmacology and Substance Abuse Division (Division 28) of the American Psychological Association (APA). The focus is on the contributions of many behavioral pharmacology researchers who collaborated very much in the spirit of an interactive community dedicated to the common cause of advancing science in service of public health. Division 28 and its members hold a prominent place in this account because, throughout the 1980s and 1990s, the Division was the lead scientific forum for bringing together researchers addressing the behavioral pharmacology of tobacco and nicotine. The commentary provides an overview of how advances utilizing animal and human models of dependence and withdrawal came to inform public health policy and more recently, tobacco product regulation. The commentary also recounts how efforts by the tobacco industry collided with those of nonindustry researchers, including Division 28 members, and how this was taken up in congressional hearings that addressed behavioral pharmacology research on tobacco. The review concludes with an overview of current challenges to behavioral pharmacology researchers to assist in guiding the regulation of tobacco products by the United States Food and Drug Administration and other national regulatory authorities, as well as guiding the implementation of the international tobacco treaty—the World Health Organization Framework Convention on Tobacco Control. (PsycINFO Database Record (c) 2011 APA, all rights reserved)