A computer-assisted expert system for clinical diagnosis of eating disorders: A potential tool for practitioners.

Updating the clinical knowledge and skills of practitioners is a critical matter for all professionals after completion of their basic core training. Expert system-based, computer-assisted training programs (ESCATs) offer the potential for achieving such ends effectively and efficiently. This article describes the development and validation of a computerized system for teaching specific information in relation to making clinical diagnoses of eating disorders. Potential implications include using ESCATs as a cost-effective means to meet continuing education requirements and staff training needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Special Licensing in Psychology.

Licensure is primarily designed to protect the public from unfit practitioners. However, most licensing laws in psychology are generic. Generic licensure assumes that there is a core of knowledge that all professional psychologists should possess and be able to document. In 1977 the New York State Board of Regents, which has jurisdiction over the licensed professions, addressed the issue of identification of specialties in the health professions. The current rules (Licensing of Psychologists in New York State, 1978) state that it is unprofessional conduct to make "claims of professional superiority which cannot be substantiated by the licensee" (p. 17). In effect, since there are no standards, psychologists can list any specialty they wish. Specialty licensing becomes important as advertising among professionals becomes a reality. The public has the right to know which psychologists are telling the truth when they list themselves as having a given specialty. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Responsibility to the population in general practice. Three years experiences with a patient-list systems in Norway

A list patient system has been tried out among general practitioners in four Norwegian municipalities for a period of three years. For some of the doctors involved the introduction of such a system led to increased work load due to mismatch between the doctor's work capacity and the number of patients on his/her list. However, the experience from the process of establishing the list provided useful knowledge and showed ways of avoiding similar problems if the system is introduced on a national basis. Waiting time for consultation has been reduced, and access to the doctor by telephone has improved. The demand for emergency on call services has been reduced because the doctors are easier to reach during the day. Patients are satisfied with the system and would like to see it become permanent. Two thirds of the GPs involved in the experiment share this standpoint.     

The general practitioner's role in breast cancer screening: a survey in Otago-Southland

AIMS: To study the experience of general practitioners in Otago and Southland with the existing breast cancer screening programme and the reviews on future programmes. METHODS: A questionnaire was sent to all 210 general practitioners in Otago and Southland in June 1996. RESULTS: The response rate was 71%. All the 141 respondents except one encouraged eligible women to take part in the programme; this was done mainly during individual doctor-patient consultations, by pamphlets and posters, and in the work of the practice nurse. Ten percent of practitioners had a practice-based recall system for breast cancer screening. Seventy-five percent of general practitioners currently provide a list of eligible women to the programme, and of these, 52% check the list to exclude ineligible women. Only 24% of practitioners supplying a patient list to the programme reported that a patient had ever requested that their name be excluded from the list. Twenty-five percent of general practitioners providing lists had a notice in the waiting room stating that. Of those who did not provide lists, concerns about logistics, ethical issues and cost were raised, although 40% of these general practitioners intended to provide lists in the future. In a future programme, 57% of general practitioners felt they should be paid for supplying lists defined by age only and 82% felt they should be paid for supplying a list of women eligible by both age and medical history. Most general practitioners felt that general practitioner lists were the preferred source for invitations to the breast screening programme and that general practitioners had an important part in any future programme. Screening at the ages 50-64 (as currently proposed) is supported by 95% of general practitioners; in addition, 64% supported screening at ages 65-69. Only a minority of general practitioners supported screening at ages 40-49 or ages 70-74. Most general practitioners would offer screening to women under age 50 with either a strong or a weak family history, or even with a past history of a fibroadenoma. CONCLUSIONS: These results show that almost all general practitioners support breast cancer screening programmes and feel that they have an important role in future programmes. The majority support extension of the programme to ages 65-69, but not to ages 40-49. The majority support screening women with individual risk factors at ages under 50, although their responses show that better information on the importance of different risk factors is required.     

Savings in a recognition test.

Tested the hypothesis that maintaining a response set from original learning to relearning is necessary to produce savings in a recognition task (RCT). 32 Ss learned 28 number–noun paired associates and 6 wks later took a 4-alternative RCT. That test was followed by a relearning trial on items from the original pairing or in new pairings. The relearning list was tested with cued recall and a 4-alternative RCT. Significant savings were found on both the recall and recognition tests. Results are discussed in terms of the paradigm and research of C. M. MacLeod (see record 1989-07460-001). (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The necessary common knowledge approach to broad and general education for professional psychologists.

This paper advocates the necessary common knowledge approach to meaningful broad and general scientific education (as distinct from professional/clinical education) for professional psychologists. Adopting this plan leads to an explicit core curriculum. The current view of the American Psychological Association's Commission on Accreditation regarding broad and general is described. “Common” and “essential” knowledge in medicine are described along with law's core curriculum. A general rationale for broad and general education is developed, and preferred kinds of experiences are suggested. As an example for psychology, a broad and general course on cognitive and affective bases of behavior is described. The way the necessary common view fits with the educational competency movement is explained. High quality broad and general education will have a positive impact on both research and professional practice. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Food restriction and binge eating: A study of former prisoners of war.

Food restriction is correlated with binge eating, but evidence that restriction leads to binge eating is scanty. In this study we investigated postwar binge eating in 67 World War II combat veterans and 198 former prisoners of war. As predicted, binge eating was relatively rare in combat veterans but was significantly more prevalent in veterans who, as prisoners in German prisoner of war camps, lost significant amounts of weight during their captivity. Our data thus support the contention that starvation or dieting seems to precede binge eating. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aided recall and list-1 retention under conditions of retroactive interference.

Attempted to determine whether list 1 retention decrements resulting from retroactive inhibition (ri)-producing list 2 learning could be reduced with recall aids. 120 male and female undergraduates serving as ss were randomly assigned to groups of 20 each. In a typical ri design, experimental ss learned 2 8-item paired-associate lists conforming to an ab-ac relationship; control ss learned only a single list. 3 types of recall conditions were used for the unpaced list 1 retention test (stimulus terms were provided in all cases): (a) standard unaided test, (b) middle 3 letters of the 9-letter response words provided, (c) initial 3 letters of response terms provided. The latter 2 conditions (aided recall) reduced ri in that control-experimental differences were reliably less on these tests than on the standard unaided test. It appears that ri results, in part, from difficulties with the retrieval of information that is available in storage. 2 views of the manner in which retrieval problems in ri can be conceptualized are discussed. (french summary) (15 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mediation and associative facilitation in neurotic, psychotic, and normal subjects.

The present investigation is a replication of previous work (see 30: 555; 27: 4925) utilizing Veterans Administration medical and psychiatric patients instead of college Ss. The previous findings indicated that associative relationship facilitates verbal learning. Ss learned 2 sets of syllable-word paired associates; ? of the pairs on the 2nd list had response terms which were associates of their responses to words on the 1st list. Although the responses of all Ss showed the effects of associative facilitation, this was more true for nonpsychotics. The results are discussed in terms of understanding the thinking of schizophrenics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pedagogical content knowledge and content knowledge of secondary mathematics teachers.

Drawing on the work of L. S. Shulman (1986), the authors present a conceptualization of the pedagogical content knowledge and content knowledge of secondary-level mathematics teachers. They describe the theory-based construction of tests to assess these knowledge categories and the implementation of these tests in a sample of German mathematics teachers (N=198). Analyses investigate whether pedagogical content knowledge and content knowledge can be distinguished empirically, and whether the mean level of knowledge and the degree of connectedness between the two knowledge categories depends on mathematical expertise. Findings show that mathematics teachers with an in-depth mathematical training (i.e., teachers qualified to teach at the academic-track Gymnasium) outscore teachers from other school types on both knowledge categories and exhibit a higher degree of cognitive connectedness between the two knowledge categories. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Serum LH concentrations in hypogonadal men during transdermal testosterone replacement through scrotal skin: further evidence that ageing enhances testosterone negative feedback. The Testoderm Study Group

As a trial of the provision of community-service information to family carers, general practitioners and pharmacists from the Western region of Melbourne were supplied with tear-off pads listing suburb-specific community services, and were encouraged to discuss service needs with carers of people with disabilities and distribute the lists to carers accordingly. One hundred and nine general practitioners and 58 pharmacists participated in pretrial and post-trial interviews assessing their knowledge of community services and frequency of discussion with carers. Before the trial, general practitioners had significantly higher self-rated knowledge of community services and reportedly discussed these with carers more often than did pharmacists. After the five-month trial period, pharmacists showed a significant increase in self-rated knowledge and frequency of discussion. General practitioners' knowledge and discussion showed a nonsignificant increase. After the trial, the two did not differ in knowledge of services; however, general practitioners maintained a higher reported frequency of discussion about services with carers. General practitioners and pharmacists appear to be well placed to act as a service link for family carers. However, additional high-intensity strategies are needed to assist them in this role.     

Review of Behavioral approaches to cardiovascular disease.

Reviews the book, Behavioral approaches to cardiovascular disease by Richard S. Surwit, Redford B. Williams Jr., and David Shapiro (1982). The authors' stated purpose in this book is to provide a complete and critical review of the state of knowledge in cardiovascular behavioral medicine (as of 1982). The organization of this volume includes four introductory chapters on the conceptual bases of behavioral medicine, summaries of cardiovascular regulation and psychophysiology, and principles of conditioning as they pertain to modifying cardiovascular functions. The core of the book consists of the next four chapters on specific disorders: coronary heart disease, hypertension, Raynaud's phenomenon, and migraine/vascular headache. A final chapter deals with selected clinical issues in the application of behavioral medicine technology. This book is generally clear and well-written, with a consistent style maintained throughout. The authors' message is presented in a manner that is likely to be accepted by physicians as well as psychologists. Unfortunately, the text occasionally presupposes a degree of knowledge of physiology and anatomy that some psychologists may lack (e.g., "attenuation of the baroreceptor-mediated inhibition of sympathetic outflow" —p. 27). This volume is likely to prove most useful to cardiovascular researchers and practitioners in cardiovascular rehabilitation programs or general medical hospitals who employ biofeedback, relaxation techniques, and life style modification procedures. Although it is no longer the "timely review" it was when first published, this book will remain a valuable reference work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Twenty-four questions (and answers) about professional practice in the area of child abuse.

Child abuse is one of the most pervasive and profoundly disturbing problems confronting the United States today. Psychologists often are confronted with complex issues surrounding child abuse in their various roles and work settings. As practitioners, psychologists need systematic knowledge of services, agencies, legislation, and regulations regarding child abuse. This article contains general information for providers who come in contact with abused children, including reporting requirements, handling disclosure, some possible effects of reporting, assessment of children who have been abused, intervention for abused children, offender issues, and resources available to psychologists. A suggested reading list is appended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diagnosis of stroke by the nonneurologist. A validation study

BACKGROUND AND PURPOSE: The first medical contact of an acute stroke victim is often a nonneurologist. Validation of stroke diagnosis made by these medical doctors is poorly known. The present study seeks to validate the stroke diagnoses made by general practitioners (GPs) and hospital emergency service physicians (ESPs). METHODS: Validation through direct interview and examination by a neurologist was performed for diagnoses of stroke made by GPs in patients under their care and doctors working at the emergency departments of 3 hospitals. RESULTS: Validation of the GP diagnosis was confirmed in 44 cases (85%); 3 patients (6%) had transient ischemic attacks and 5 (9%) suffered from noncerebrovascular disorders. Validation of the ESP diagnosis was confirmed in 169 patients (91%); 16 (9%) had a noncerebrovascular diagnosis. Overall, the most frequent conditions misdiagnosed as stroke were neurological in nature (cerebral tumor, 3; subdural hematoma, 1; seizure, 1; benign paroxysmal postural vertigo, 1; peripheral facial palsy, 2; psychiatric condition, 6; and other medical disorders, 7). CONCLUSIONS: In the majority of cases, nonneurologists (either GPs or ESPs) can make a correct diagnosis of acute stroke. Treatment of acute stroke with drugs that do not cause serious side effects can be started before evaluation by a neurologist and CT scan.     

Attenuating anterograde amnesia in Korsakoff's Psychosis.

Attempted to attenuate the severe anterograde amnesia of a 52-yr-old male patient with Korsakoff's Psychosis through the imposition of cues to assist memory. Categorized word list recall was dramatically increased only when cues at both storage and retrieval were employed. Information necessary to independent functioning on the ward was also learned by providing storage and retrieval cues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cortisol differentially affects memory in young and elderly men.

Nine young and 11 elderly men participated in this placebo-controlled, double-blind, crossover study (0.5 mg/kg cortisol or intravenous placebo). Participants learned a word list before cortisol administration, and delayed recall was then tested. A 2nd word list was learned and recalled after drug administration. In addition, the Paragraph Recall Test and tests measuring working memory (Digit Span), attention (timed cancellation), and response inhibition (Stroop Color and Word Test) were administered at 2 time points after drug administration. Cortisol reduced recall from the word list learned before treatment in both groups but did not influence recall of the list learned after treatment. In contrast, Digit Span performance was decreased by cortisol in young but not elderly participants. The possibility that differential age-associated brain changes might underlie the present results is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Distinguished Scientific Contribution Awards: 1969: Citation for Stanley Schachter.

Gives a citation to Stanley Schachter "For consistent, coherent, and creative work that has materially advanced our understanding of behavior in social contexts. He has chosen to explore new areas and new problems that promised to be important and applied exceptional experimental ingenuity in making his explorations successful. Bringing to bear on his problems a fine sense of the necessary relation between theory and data, his studies always produced meaningful knowledge. By exploring his ideas in natural setting:; as well as in the laboratory, he kept richness and precision together in his work. The measure of a man's contribution to science is what we have learned as a result of his work. From the work of Stanley Schachter we have gained new knowledge of the social psychological effects of being deviant in a group; of the circumstances under which people seek out others and the basic: nature of group support; of how groups provide the context within which emotions are defined; and even the effects of the social context on psychophysiological effects. He has contributed broadly and deeply." The citation is followed by a biography of Schachter and a list of his scientific publications. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Economic aspects of anesthesia. I. Health care reform in the German Republic

Implications for Hospitals and Departments of Anaesthesiology. This article outlines the new German health care laws and their impact on the statutory health care system, hospitals and anaesthesia departments. The German health care system provides coverage for all citizens, although financial support from the public sector is on the downgrade. Hence, pressure to reduce public sector health care spending is likely to continue in the near future. Hospital costs account for one-third of total health care spending in Germany, and hospitals are facing increasing economic constraints: the volume and the charges for specific medical treatments are negotiated between the hospitals and the insurance agencies (or sickness funds) in advance. Only part of hospital care is still reimbursed on the basis of a per diem rate, and an increasing number of services are based on fixed payments per case or treatment. Reducing the costs for this treatment is therefore of utmost importance for hospitals and hospital departments. The prospective payment system and the pressure to contain costs demand a controlling system that allows for cost accounting per case. However, an economic evaluation must include comparative analysis of alternative therapeutic options in terms of both costs and outcome. Economic aspects challenge the traditional relationship between physicians and patients: doctors are still the advocates of their patients, but also act as agents for their institutions. Nevertheless, not only economic issues, but also ethical priorities and the value of an anaesthetic practice must be considered in the era of cost containment. Anaesthetists must be actively involved in providing high-quality care with its obvious benefits for the patient and be able to resist efforts to cut out expensive treatment modalities regardless of their benefits.