Simultaneous communication with autistic and other severely dysfunctional nonverbal children

Despite its widespread application, the teaching of speech does not appear to be effective with all autistic and other severely dysfunctional, nonverbal children. A body of recent evidence points to the peculiarities in the information processing of these children and to the importance of gestures as aids or alternatives to speech. The present study reports on the use of simultaneous communication (gestures plus speech) with five such children. The fact that four of the five children showed marked gains in their ability to communicate over a 5-week period raises some theoretical and methodological issues pertinent to the treatment of autistic and autistic-like children and to our general understanding of the processes involved in nonverbal communication.     

Teaching headache management to medicine residents

BACKGROUND: To evaluate the effect of teaching headache management to PG-1 medicine residents. DESIGN: Observational study using prerotation and postrotation ratings by residents of improvement in their knowledge of etiology, diagnosis, appropriate use of narcotics, and treatment of headache. SETTING: Veterans Affairs Outpatient Clinic. PARTICIPANTS: Twenty-two medicine residents. MEASUREMENTS AND RESULTS: There was small but significant improvement in the total knowledge score (P = .03) and in areas of etiology of headache (P = .02) and appropriate use of narcotics (P = .001). CONCLUSION: We found there were substantial increases in residents subjective levels of understanding, history-taking and in the diagnosis and treatment of headache (P < .0001) in contrast to the objective knowledge test.     

Teaching medical ethics to orthopaedic surgery residents

Orthopaedic surgery residents will be faced with a variety of ethical issues when they enter clinical practice. A previous survey suggested that they lack knowledge about how to approach several types of medical ethics dilemmas. We developed a medical ethics curriculum for orthopaedic surgery residents and presented it over a one-year period to the residents in one training program. The effect of the educational intervention on the residents' knowledge of medical ethics and their ability to handle hypothetical situations was measured by comparing their responses to a questionnaire, administered before and after the intervention, with those of residents in a training program in which the intervention was not provided. The twenty-five residents at the site of the educational intervention had a mean improvement of 0.10 in the overall score, from a mean score of 0.71 on the baseline survey to a mean score of 0.81 on the follow-up survey. This improvement was significantly greater than the mean improvement of 0.02 for the thirty residents at the control site, who had a mean score of 0.72 on the baseline survey and a mean score of 0.74 on the follow-up survey (p = 0.002). Six residents who participated in the medical ethics curriculum rated it as very useful; seventeen, as somewhat useful; one, as slightly useful; and one, as not at all useful. A medical ethics curriculum can increase orthopaedic residents' knowledge of medical ethics. Whether this curriculum also will lead to behavioral changes requires additional evaluation.     

Teaching psychological testing to psychiatric residents.

Psychologists can help alleviate the disenchantment with testing by participating in the training of psychiatric residents. Such training should familiarize residents with the basic principles of testing to help them become sophisticated consumers of the psychologist's consultative service rather than test practitioners themselves. This introduction of testing to residents must take into account their specific educational needs, especially the difficulties they have in learning psychological constructs early in their career, due to the physicalistic orientation of their former training. Of equal importance to teaching the principles of assessment is the elucidation of the collaborative diagnostic effort as an interpersonal process with opportunities for cooperation or interdisciplinary friction. The landmarks and pitfalls encountered during the collaborative diagnostic process involving psychologist and psychiatrist are outlined as crucial issues to be covered in training to help foster improved teamwork between the 2 disciplines. The sources of political friction that can arise when psychologists train psychiatrists are discussed. (42 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Teaching residents to care for culturally diverse populations

The authors discuss the growing need for primary care residents to learn how to care for patients of many cultural backgrounds. To effectively learn the needed skills, residents must incorporate insights from areas outside medicine. The authors focus on three such areas: cultural competency, public health, and community-oriented primary care. Regarding cultural competency, the authors make clear that on the one hand, physicians must be trained to be sensitive to cultural differences and patterns, but on the other, they cannot be expected to know the many cultures of their patients in depth. They discuss the Core Curriculum Guidelines on Culturally Sensitive and Competent Health Care created by the Society of Teachers of Family Medicine. Regarding community-oriented primary care (COPC), a process introduced from Europe in 1982, the authors state that one of its key elements is to provide accessible care to diverse and often underserved populations. However, various factors have kept COPC, and the federally funded community health centers that address the concerns of COPC, from having the widespread effects they could have. Regarding public health, the authors review the various services and orientations of public health and show how these help foster care for diverse populations. The authors then briefly describe their own residency program and its work with diverse populations. They conclude by emphasizing the importance for residents of learning the principles and practices embodied in cultural competency, public health, and COPC in order to effectively communicate with their patients.     

Responses to occupational hazards: exit and participation

The authors developed and tested a model linking subjective risk perceptions to both turnover intentions and employees' willingness to participate in health and safety programs. On the basis of data from 130 employees of a manufacturing firm, the model was supported. Risk perceptions were predicted by employees' accident history and perceptions of others' commitment to health and safety. In turn, risk perceptions predicted both turnover intentions and willingness to participate. These effects emerged after controlling for monomethod bias.     

Teaching behavioral science to family medicine residents: integrating training into the family practice unit

INTRODUCTION: Physicians need to be well trained in HIV risk assessment interview skills. Little has been written in the literature concerning training methods for this specialized interview. METHODS: One model to teach the HIV risk assessment interview has been developed and has been used to teach third-year medical students. We compared this interactive model, which uses simulated patients to teach HIV Risk Assessment, to a didactic one. Twelve medical residents were taken through either the interactive session or the didactic session. Pre-post changes from questionnaires were calculated to determine any differences in sessions. Also, Objective Structured Clinical Examinations (OSCEs) were used to grade all residents 2 weeks after their sessions. RESULTS: All pre-post changes were calculated and no statistically significant differences were seen (P > 0.50). OSCE interpersonal skills scores and content scores were calculated. The interactive group had statistically significantly higher scores (P < 0.05). CONCLUSION: The data supports the conclusion that an interactive method is more effective to use to train HIV risk assessment interview skills to medical residents when compared to the didactic method.     

Pathways to labor force exit: work transitions and work instability

The purpose of this study is to examine alternative pathways to labor force exit among older men. Based on the life course perspective, we distinguish between crisp exits from the labor force, which are characterized as being unidirectional, and blurred transition patterns, which include repeated exists, entrances, and unemployment spells. Using longitudinal data from the 1984 Survey of Income and Program Participation, we find that one-quarter of the sample of men aged 55 to 74 at first interview experienced at least one transition in labor force status over a 28-month observation period. Fewer than half of these can be characterized as crisp exists from the labor force. Our multivariate analysis suggests that blurred transition patterns are likely part of an effort to maintain economic status in later life.     

Measurements of exit rates to distinguish between facilitated and simple diffusion

A modification of the method of Sen and Widdas (J. Physiol. London 160:392-403, 1962) was used to measure the rate of exit of several nonelectrolytes from erythrocytes of various species. In spite of additional errors introduced by the larger half-saturation values of the carriers (phi) and concentrations, it was possible to distinguish between systems with small values of phi, systems with relatively large values of phi, and systems involving only simple diffusion. Approximate values of phi in millimoles and of maximum transfer rate (K) in isotonic units per minute were obtained using times and initial slopes measured on experimental curves. The following values in the foregoing units were obtained: human glucose, phi = 1.8, 1.0, K = 0.8, 1.1; human glycerol, phi = 178, 94, K = 4.3, 3.3; sheep thiourea, phi = 56, 56, K = 0.9, 0.6; and rabbit glycerol, phi = 328, 64, K = 2.2, 1.0. Simple diffusion was demonstrated for the following systems: ox-ethylene glycol; ox-glycerol; sheep-ethylene glycol; and sheep glycerol.     

Modeling hydrogen entry and exit in metals exposed to multiple charging processes

A model is presented to evaluate hydrogen entry or exit in metals exposed to an aqueous environment. The model may be used to analyze data obtained from hydrogen permeation experiments through metal membranes. The model takes advantage of the ideal behavior predicted from the Nernst Equation and Sievert’s Law. It provides a single parameter,κ, to quantify the deviation from Sievert/Nernstian behavior. It is sufficiently general to allow arbitrary chemical potentials of hydrogen on both sides of a sheet, in addition to an arbitrary initial hydrogen distribution within a metal sheet. Simulated permeation curves are presented to show the influence of the model parameters upon permeation behavior. The model is applied to solution agitation during permeation of a low-carbon steel sheet as an illustration. By curve-fitting the model to experimental data, the diffusivity, surface solubilities, andκ on both sides of a metal sheet may be obtained for a given electrochemical charging condition. When compared to other popular models, the model presented by this article fit the experimental data well. The parameters obtained by the model may be used to characterize a given charging process. As such, the effect of one or more processes may be evaluated by using the model to calculate hydrogen distributions in a metal sheet.     

Desensitization to media violence: Links with habitual media violence exposure, aggressive cognitions, and aggressive behavior.

This study examined the links between desensitization to violent media stimuli and habitual media violence exposure as a predictor and aggressive cognitions and behavior as outcome variables. Two weeks after completing measures of habitual media violence exposure, trait aggression, trait arousability, and normative beliefs about aggression, undergraduates (N = 303) saw a violent film clip and a sad or a funny comparison clip. Skin conductance level (SCL) was measured continuously, and ratings of anxious and pleasant arousal were obtained after each clip. Following the clips, participants completed a lexical decision task to measure accessibility of aggressive cognitions and a competitive reaction time task to measure aggressive behavior. Habitual media violence exposure correlated negatively with SCL during violent clips and positively with pleasant arousal, response times for aggressive words, and trait aggression, but it was unrelated to anxious arousal and aggressive responding during the reaction time task. In path analyses controlling for trait aggression, normative beliefs, and trait arousability, habitual media violence exposure predicted faster accessibility of aggressive cognitions, partly mediated by higher pleasant arousal. Unprovoked aggression during the reaction time task was predicted by lower anxious arousal. Neither habitual media violence usage nor anxious or pleasant arousal predicted provoked aggression during the laboratory task, and SCL was unrelated to aggressive cognitions and behavior. No relations were found between habitual media violence viewing and arousal in response to the sad and funny film clips, and arousal in response to the sad and funny clips did not predict aggressive cognitions or aggressive behavior on the laboratory task. This suggests that the observed desensitization effects are specific to violent content. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The relation of empathy to aggressive and externalizing/antisocial behavior.

A number of researchers have proposed that empathy, sympathy, or both, defined primarily in affective terms, may inhibit aggressive and antisocial behaviors (N. D. Feshbach & S. Feshbach, 1982; S. Feshbach, 1970; Parke & Slaby, 1983). In this review, we organized the relation of empathy/sympathy to relevant negative behaviors principally by mode of assessing empathy (i.e., picture/story, questionnaire methods, facial/gestural reactions, and experimental inductions) and analyzed empirical findings with meta-analytic techniques. Empathic/sympathetic responding was negatively related to aggression and antisocial, externalizing behaviors for questionnaire methods and negatively but nonsignificantly related for other indexes of empathy. Child abuse also was associated with low levels of empathy/sympathy, as was the receipt of such abuse. Relations between the empathy indexes and aggression/externalizing behaviors were generally the same for male and female subjects, especially after controlling for sample size. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of avoidance in aggressive responses to attack and no attack.

In 2 experiments male Ss interacted with a presumed opponent in a task that permitted the 2 participants to exchange various intensities of shock, including a zero intensity. The Ss' responses were considered separately following attack (receipt of shock) and no attack (no receipt of shock). For responses following no attack, the Ss' aggressive behavior varied with their ability to avoid further shock. Relative to controls, Ss who could avoid further shock by nonaggression (Exp I, 40 college students) were less aggressive. Those who could avoid shock by being very aggressive (Exp II, 20 college students) were more aggressive than controls. Aggressive responses following attack, however, were not influenced by avoidance contingencies. The ability to avoid further shocks apparently influenced males' aggressive responses in the absence of attack but failed to influence males' aggressive responses to attack. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Polyploidization and exit from cell cycle as mechanisms of cultured melanoma cell resistance to methotrexate

Numerous malignant neoplasias are found to contain varying proportions of high-ploidy cells. Although the role they play in the tumor is poorly understood, several lines of evidence suggest that these cells could be especially resistant to various aggressions, a possibility of great interest in cancer treatment. In the present study, we tested this hypothesis through the analysis of the presence of high-ploidy cells following the administration of the chemotherapeutic agent methotrexate. We also determined the expression of two proliferation markers, PCNA and CDK1, after methotrexate-treatment. Cultured cells from the murine melanoma B16F10 were treated with high doses of methotrexate for seven days prior to determination of DNA content and proliferation markers. Our results showed an obvious increase in the mean ploidy of this population. Specifically, there was a dramatic reduction in the proportion of tetraploid cells (predominant in the original population), and an increase in the proportion of cells with higher ploidies, particularly those whose DNA content was greater than 8c, including some cells with ploidies greater than 16c. Furthermore, there was a reduction in the number of PCNA-expressing cells and the reduction was much more marked in the case of CDK1 that was almost absent in the modal-ploidy treated cells. These alterations concerning ploidy and expression of proliferation markers had completely reverted two weeks after withdrawal of the drug. Our results indicate that methotrexate at a high dosage selects a cell population heterogeneous concerning its ploidy level, composed of one subpopulation of high-ploidy cells and another of modal-ploidy cells that, considering its lack of CDK1 expression, would remain in a latent state to evade the effects of the drug.     

Potential chlorpyrifos exposure to residents following standard crack and crevice treatment

Multipathway exposures were evaluated for residents of houses over a 10-day period following a crack and crevice application of a chlorpyrifos-based formulation. Three multiroom houses with two adults each were treated. Air concentration, total deposition, and dislodgeable residues on horizontal surfaces were measured to assess potential respiratory, oral, and dermal exposures, respectively, in treated and untreated high activity rooms. In addition, urine samples collected from the adults were analyzed for the primary metabolite of chlorpyrifos, 3,5,6-trichloropyridinol, to determine absorbed dose. The maximum chlorpyrifos air concentration observed was 2.3 microgram/m3, with air concentrations generally decreasing to levels ranging from 0.1 to 0.3 microgram/m3 within 10 days. Carpet dislodgeable residues, used to evaluate the amount of residues potentially transferred upon contact, were less than the analytical method limit of quantitation (1.6 microgram/m2). Hard plastic balls placed in the homes on the day before application contained no detectable dislodgeable residues (<6.5 microgram/m2). Ten-day cumulative nontarget residues deposited on surfaces, as determined by deposition pads, were less than 2.3 microgram/100 cm2. Deposition samples from all living area floors collected 2 hr after application contained less than 9.9 microgram/100 cm2. Therefore, contact with household surfaces and subsequent hand-to-mouth activity are not expected to significantly contribute to overall exposure. Estimated exposures to children, based on the passive dosimetry measurements, ranged from 0.26 to 2.1% of the no observed effect level for plasma cholinesterase depression. In addition, potential exposures to the adult residents, as indicated by the urinary 3,5,6-TCP biomonitoring, did not increase as a result of the application.     

Sexual arousal to erotic and aggressive stimuli in sexually coercive and noncoercive men.

Sexual arousal to erotic stimuli depicting various levels of force were examined among college men. Study 1 used phallometric indices to measure penile circumferential change during combined audiotape and slide presentations varying in degree of force. The results indicated that the sexually coercive group exhibited more penile tumescence than controls to scenes involving verbal pressure and verbal threats. Analyses across time blocks suggested that control participants inhibited sexual arousal with the introduction of force cues but that the sexually coercive group did not. Study 2 was a replication of Study 1 without slides. Both groups showed increases in penile tumescence in response to the consent scenario. Only the sexually coercive men demonstrated significant tumescence in response to force scenarios. The results indicated that the sexually coercive males had a lower threshold for arousal to sexual cues and did not inhibit sexual arousal when force cues were introduced. (PsycINFO Database Record (c) 2010 APA, all rights reserved)