Billing a patient''s medical insurance

Some nurses have the goal to lead others and to be in charge of patient groups and groups of staff. They want to make changes at the upper levels of the organization and see their actions affect large numbers of people. Many others, however, really desire to be a bed-side nurse giving excellent patient care. They want to enjoy the close relationship that can make an individual feel better about him or her self as a person and the satisfaction that they have made a difference in one person's life. However, whether the nurse leads through a management position or practices leadership techniques in bedside nursing, all nurses are leaders and need to demonstrate expertise in the use of leadership techniques.     

Environmental contingency in life history strategies: The influence of mortality and socioeconomic status on reproductive timing.

Why do some people have children early, whereas others delay reproduction? By considering the trade-offs between using one's resources for reproduction versus other tasks, the evolutionary framework of life history theory predicts that reproductive timing should be influenced by mortality and resource scarcity. A series of experiments examined how mortality cues influenced the desire to have children sooner rather than later. The effects of mortality depended critically on whether people grew up in a relatively resource-scarce or resource-plentiful environment. For individuals growing up relatively poor, mortality cues produced a desire to reproduce sooner—to want children now, even at the cost of furthering one's education or career. Conversely, for individuals growing up relatively wealthy, mortality cues produced a desire to delay reproduction—to further one's education or career before starting a family. Overall, mortality cues appear to shift individuals into different life history strategies as a function of childhood socioeconomic status, suggesting important implications for how environmental factors can influence fertility and family size. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Knowledge of and interest in geropsychology among psychology trainees.

Given the increasing number of older people in the U.S. population, how well prepared are graduate students to deliver services to older adults? Do graduate students want to see older adults in clinical practice? Ninety-four psychology externs and interns were surveyed about their knowledge of and attitudes toward older people. Although trainees evidenced gaps in knowledge, they indicated interest in expanding that knowledge. They also reported favorable attitudes toward the aged and interest in practice with them. This article summarizes geropsychology resources for graduate program directors, students, and practitioners who want to expand practice to include older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Outcasts in a white-lie society: The enigmatic worlds of people with negative self-conceptions.

Although people with negative self-views want to be liked at some level, they repeatedly enact behaviors that alienate their relationship partners. Why? One possibility is that such persons reside in social environments that offer them little insight into what they are doing wrong. Although persons who had negative self-views elicited unfavorable reactions, they did not appreciate this fact because their interaction partners concealed their aversion behind a facade of kind words. To be sure, the interaction partners of people with negative self-views tended to leak their disdain nonverbally. These negative nonverbal messages proved to be uninformative, however, because people with negative self-views overlooked them. These data imply that people with negative self-views may live in social worlds in which they are deprived of corrective feedback that could allow them to improve themselves. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Letters from California--the safety police

I am sure many people imagine the United States of America as the land of the free, where people can do what they want unfettered by unnecessary rules, regulations and taxation. Unfortunately, the truth is very different and there are as many rules and regulations in the USA as almost anywhere else, and in some cases they are more complex since regulations come from both the federal government and the state government. Both may pass similar laws which differ in small degrees so there may be considerable areas of overlap but also considerable differences between the federal and state regulations. For dentists, a particular area of concern in recent years has been the agency known as OSHA, the Office of Safety and Health Administration.     

The potential value of small responses and partial solutions

At the turn of the century, Taiwan's population was increasing slowly, then later grew during a period of high fertility after the end of World War II and the accordance of independence in 1946. This growth in fertility came together with increasing life expectancy and a general desire by couples to have families comprised of 5-6 children. Taiwan was therefore poised to experience a major population explosion. In this context, a family planning program was established in the country which has since evolved into one of the world's most successful such programs. By 1990, the preferred family size was 2-3 children and of couples which already had 2 children, 70% of those without any sons were nonetheless practicing contraception. While in 1965, no married women used contraception until they had some children, by 1990, 27% of married women without children used contraception. Increasing age at marriage has been an important factor in Taiwan's declining fertility, with the average age at marriage increasing from 20 years in the 1950s to approximately 27 in the 1970s. Few mothers, however, want only one child. The fertility trends observed in Taiwan have been made possible through the provision of contraception, which used to be universally free, but which is now provided free to only people of low income or the disabled. Oral contraception, condoms, and IUDs are used, although 30% of couples depend upon sterilization.     

Resource allocation and resident outcomes in nursing homes: comparisons between the best and worst

This article examines ethical dilemmas related to cochlear implant surgery in children. These dilemmas arise from the existence of a linguistic and cultural minority called the Deaf World. Organizations of culturally Deaf adults in the United States and abroad, as well as the World Federation of the Deaf, have, on ethical grounds, strongly criticized the practice of cochlear implant surgery in children. Three ethical dilemmas are examined. (1) The surgery is of unproven value for the main significant benefit sought, language acquisition, whereas the psychological, social, and linguistic risks have not been assessed. Thus the surgery appears to be innovative, but innovative surgery on children is ethically problematic. (2) It is now widely recognized that the signed languages of the world are full-fledged natural languages, and the communities that speak those languages have distinct social organizations and cultures. Deaf culture values lead to a different assessment of pediatric cochlear implant surgery than do mainstream (hearing) values, and both sets of values have standing. (3) The fields of otology and audiology want to provide cochlear implants to Deaf children but also, their leaders say, want to protect Deaf culture; those appear to be conflicting goals in principle because, if there were perfect implants, the ranks of the Deaf World would diminish.     

Review of Language development in the preschool years.

Reviews the book, Language development in the preschool years by Gordon Wells (1985). This is the second report of a massive study of child language that has come to be known as "the Bristol study." It was carried out on local children by members of the University of Bristol. It is the best longitudinal study of its type that I have seen. Educators will find the book useful. Many people are worried about the "permissible" limits of variability: when a child is to be treated as normal and when professional intervention is required. The book gives no precise rules, but it can help to inform judgement. Taking one thing with another, the book is replete with useful information that the student of child language will not want to be without. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Authenticity and positivity strivings in marriage and courtship.

Proposed that married persons would want their spouses to see them as they saw themselves but that dating persons would want their relationship partners to evaluate them favorably. A survey of 176 married and dating couples tested these predictions. Just as married persons were most intimate with spouses whose evaluations verified their self-views, dating persons were most intimate with partners who evaluated them favorably. For married people with negative self-views, then, intimacy increased as their spouses evaluated them more negatively. Marriage apparently precipitates a shift from a desire for positive evaluations to a desire for self-verifying evaluations. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Obesity: evaluation and treatment

Obesity as a chronic condition among large numbers of people is a disease of recent origin, often but by no means always associated with dietary habits and sedentary lifestyle. Many obese people want to lose weight, and may have tried to do so numerous times with self-help or proprietary weight-loss programs. When they seek a physician for help in losing weight-or when a physician advises an obese patient to lose weight as part of a clinical strategy-care must be taken to "match" the patient to an appropriate therapeutic program with appropriate therapeutic goals. History and physical examination and psychologic evaluation are essential elements of patient screening. Complications of obesity must be taken into account in any treatment plan. The multidisciplinary management strategy is most likely to succeed in helping the patient lose weight. It also avoids untoward events associated with complications or concomitant disease. The multidisciplinary approach is especially important when the patient does not lose weight, and alternative strategies must be considered, such as surgical approaches.     

Psychological models of the justice motive: Antecedents of distributive and procedural justice.

Two psychological theories consider why people care about justice. The social-exchange-based resource model argues that people want to maximize the resources they obtain from social interactions, a goal that they believe is facilitated by following rules of distributive and procedural justice; the identity-based relational model suggests that people attempt to maintain high status within groups and use the justice of their experiences to evaluate their group status. Two studies on reactions to experiences with authorities (legal and managerial) examine the influence of these motives on (1) people's evaluations of the distributive and procedural justice of their experiences and (2) affective and behavioral reactions to those experiences. Results support a model in which relational issues dominate definitions of justice. Whereas distributive justice judgments are shaped by both resource and relational judgments, procedural justice judgments are shaped by relational concerns. The findings suggest two distinct justice motives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The laparoscopic sterilization of women

The optimal time for sterilization is 24-36 hours after childbirth or during the 8th week in the postpartum period. The surgical methods of sterilization of the ovarian ducts are simple, harmless, effective, reversible, economical, and voluntary. These considerations also apply to endoscopic methods. For the occlusion of ovarian ducts, electrical current (monopolar and bipolar) and mechanical means (Yoon ring, Hulka and Filshie clips) are used. Unipolar coagulation of the ovarian ducts is another method of surgical sterilization done by laparoscopy. The area of coagulation occupies about 1.5 cm. The length of bipolar coagulation is 10 times larger than the unipolar coagulation site. Patients can be released 4 hours or the next day after the operation. The frequency of complications with bipolar coagulation is low: burning occurs in 0.04-0.1% of cases and bleeding from the mesosalpinx in 0.16-0.5%. The incidence of pregnancy after the operation amounts to 0.1-0.4%. Mechanical methods of sterilization are also reliable, although they are not suitable for all women. For young women who may still want children it is uniquely expedient to employ the Hulka or Filshie clips. In the rest of the cases the Yoon ring can be used, which was first used in the US in 1972 and became popular subsequently. The rate of complications is rare with its use (0.12-3.75%), and pregnancy occurs in 0.08-0.4% of cases. The incidence of complications with the use of clips amounts to 0-0.71%, the pregnancy rate is 0-0.59%, and the possibility of reversal is 80-100%. This method is ideal for young women who do not want to use other contraceptives and who want to have more children.     

Review of Two Hugs for Survival.

Reviews the book, Two Hugs for Survival by Harold A. Minden (1982). Parenthood is not natural, and children have the right to trained parents. Two Hugs for Survival is an informative, sensitive, and supportive parent training book based on these two premises. Drawing on 15 years of contact with parents in educational and clinic situations, Harold Minden outlines a number of principles and strategies characterizing successful parents. This book is a thoroughly readable anthology of strategies for parents interested in increasing their coping vocabulary. While research and theoretical underpinnings are not as explicit as they might be, case studies and detailed instructions for applying particular suggestions are introduced effectively. This book is recommended for those who want answers to specific child-rearing questions. The only danger is that it may appeal most to those interested in a quick-fix approach to their frustrations as parents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motivated sensitivity to preference-inconsistent information.

If preference-inconsistent information initiates more effortful cognitive analysis than does preference-consistent information, then people should be more sensitive processors of information they do not want to believe than of information they do want to believe. Three studies supported this prediction. Study 1 found that inferences drawn from favorable interpersonal feedback revealed a correspondence bias, whereas inferences drawn from unfavorable feedback were sensitive to situational constraint. Study 2 showed this sensitivity to the quality of unfavorable feedback to disappear under cognitive load. Study 3 showed that evaluations of the accuracy of favorable medical diagnoses were insensitive to the probability of alternative explanation, whereas evaluations of unfavorable diagnoses were sensitive to probability information. The importance of adaptive considerations in theories of motivated reasoning is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beyond the birds and the bees and was it good for you?: Thirty years of research on sexual communication.

Sexual experience and expression is of fundamental importance to most people. However, most people do not communicate effectively about sexuality even when it is important to do so. For example, many parents see it as their responsibility to talk to their children about sexuality and yet do not engage in in-depth discussions with their children about sexual topics. Most romantic partners have difficulty telling each other what pleases and displeases them sexually. Many health care professionals do not meet their patients' needs for information about the sexual changes they experience as a result of their disease or treatment. Many psychologists also are not doing a good job of addressing sexuality in the classroom, in practicum and internship settings, and/or with clients. These instances of poor sexual communication are unfortunate as effective sexual communication can have a range of positive outcomes such as more satisfying relationships and positive sexual health and well-being over the life span. This paper reviews sexual communication in all of these contexts, focusing on findings from my program of research spanning more than 30 years. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Privileged Treatment of Toddlers: Cultural Aspects of Individual Choice and Responsibility.

This study examined the idea that toddlers in some communities are accorded a privileged status in which they are allowed what they want, assumed not yet to "understand" how to cooperate. U.S. middle-class and Guatemalan Mayan mothers and 3- to 5-year-old siblings were observed while the siblings and toddlers (14-20 months) both sought access to attractive objects. The Mayan toddlers' desires were usually respected by both the mothers and the siblings, who often voluntarily cooperated without mothers' intervention. In contrast, the U.S. middle-class toddlers seemed to be expected to follow the same rules for sharing (with some leniency) as the older children. The Mayan pattern fits a cultural model prioritizing both responsibility and respect for others' freedom of choice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Growing number of overseas adoptions leads to recommendations from Manitoba MDs

Four Manitoba physicians have developed recommendations to help doctors provide medical advice and counselling to families that want to adopt children from foreign countries. Foreign adoptions are appealing to would-be parents, who might wait years to adopt a Canadian-born child, but in many countries there is a high risk that children placed for adoption will have medical conditions, infectious diseases and developmental problems.     

Abortion patients in 1994-1995: characteristics and contraceptive use

Results of a 1994-1995 national survey of 9,985 abortion patients reveal that women who live with a partner outside marriage or have no religious identification are 3.5-4.0 times as likely as women in the general population to have an abortion. Nonwhites, women aged 18-24, Hispanics, separated and never-married women, and those who have an annual income of less than +15,000 or who are enrolled in Medicaid are 1.6-2.2 times as likely to do so; residents of metropolitan counties have a slightly elevated likelihood of abortion. When age is controlled, women who have had a live birth are more likely to have an abortion than are those who have never had children. Catholics are as likely as women in the general population to have an abortion, while Protestants are only 69% as likely and Evangelical or born-again Christians are only 39% as likely. Since 1987, the proportion of abortions obtained by Hispanic women and the abortion rate among Hispanics relative to that for other ethnic groups have increased. The proportion of abortion patients who had been using a contraceptive during the month they became pregnant rose from 51% in 1987 to 58%. Nonuse is most common among women with low education and income, blacks, Hispanics, unemployed women and those who want more children. The proportion of abortion patients whose pregnancy is attributable to condom failure has increased from 15% to 32%, while the proportions reporting the failure of other barrier methods and spermicides have decreased.