The development of the physicians' end-of-life care attitude scale

The Physicians' End-of-Life Care Attitude Scale (PEAS) was developed as an outcome measure for palliative care education. PEAS assesses the willingness of medical trainees to care for dying patients. Sixty-four Likert-type questions were created on the basis of discussions with focus groups of medical trainees, then administered to sixty-two medical students and residents. Total PEAS scores as well as personal preparation and professional role subscales (where higher scores indicated greater concern) possessed excellent internal consistency and reliability. In addition, there were substantial correlations between PEAS scores and the CA-Dying scale, a measurement of laypersons' fears about interacting with dying persons. Thus, PEAS adequately assesses the unique communication concerns of physicians in training regarding working with dying persons and their families. Correlations between PEAS scores and age were negative, while those who had experienced the death of a loved one had higher PEAS scores than those who did not. This suggests that for some persons, life experiences may lessen difficulties in dealing with dying persons, while for others, personal losses may exacerbate such concerns. The utility of PEAS in evaluating the efficacy of palliative care education as well as its potential to measure medical trainee's willingness to care for the terminally ill is discussed.     

Residential Building Codes,Affordability, and Health Protection: A Risk-Tradeoff Approach

Residential building codes intended to promote health and safety may produce unintended countervailing risks by adding to the cost of construction. Higher construction costs increase the price of new homes and may increase health and safety risks through income and stock effects. The income effect arises because households that purchase a new home have less income remaining for spending on other goods that contribute to health and safety. The stock effect arises because suppression of new-home construction leads to slower replacement of less safe housing units. These countervailing risks are not presently considered in code debates. We demonstrate the feasibility of estimating the approximate magnitude of countervailing risks by combining the income effect with three relatively well understood and significant home-health risks. We estimate that a code change that increases the nationwide cost of constructing and maintaining homes by $150 (0.1% of the average cost to build a single-family home) would induce offsetting risks yielding between 2 and 60 premature fatalities or, including morbidity effects, between 20 and 800 lost quality-adjusted life years (both discounted at 3%) each year the code provision remains in effect. To provide a net health benefit, the code change would need to reduce risk by at least this amount. Future research should refine these estimates, incorporate quantitative uncertainty analysis, and apply a full risk-tradeoff approach to real-world case studies of proposed code changes.     

Experiment-dependent priors in psychology and physics

Sometimes conducting an experiment to ascertain the state of a system changes the state of the system being measured. Kahneman & Tversky modelled this effect with support theory. Quantum physics models this effect with probability amplitude mechanics. As this paper shows, probability amplitude mechanics is similar to support theory. Additionally, Viscusi's proposed generalized expected utility model has an analogy in quantum mechanics.     

Do male dropouts benefit from obtaining a GED, postsecondary education, and training?

The authors use longitudinal data from the National Longitudinal Survey of Youth to investigate whether the wage trajectories of male high school dropouts are affected by the acquisition of the General Educational Development (GED) credential, by postsecondary education, and by training. The authors show that acquisition of the GED results in wage increases for dropouts who left school with weak skills, but not for dropouts who left high school with stronger skills. College and training provided by employers are associated with higher wages for male dropouts.     

Death at the border

"Debates about United States border control policies have generally ignored the human costs of undocumented migration. We focus attention on these costs by estimating the number, causes and location of migrant deaths at the southwest border of the United States between 1993 and 1997.... Deaths from hyperthermia, hypothermia and dehydration increased sharply from 1993 to 1997 as intensified border enforcement redirected undocumented migration flows from urban crossing points to more remote crossing areas where the migrants are exposed to a greater risk of death."     

Negative impact of sexual abuse on adult male gender: Issues and strategies of intervention

Although male sexual abuse has co-existed with female sexual abuse, the professional literature has paid minimal attention to the impact of sexual abuse of male children to their adult adaptation. This paper concentrates on the negative impact of sexual abuse on the adult male's gender identity. Examples of eight male clients' responses to sexual abuse in their adult life and the therapeutic framework utilized to work with them are discussed in the paper.This paper was originally presented at the ICAPP conference, 1993.He teaches advanced clinical practice, Human Behavior and AIDS ELECTIVE. He maintains a private practice specializing in Gay men, persons with HIV virus.     

Bayesian robustness for multiparameter problems

Bayesian robustness is studied for ε-contamination classes of prior distributions. Nonparametric classes of contsminations such as the class of all unimodal spherically symmetric densities are considered here. Posterior φ-divergence and its curvature are used to measure the sensitivity of priors on the resulting posterior densities. Examples are provided to illustrate our results.     

THE USE OF INTERACTIVE VIDEO TO DEMONSTRATE DIFFERENTIAL APPROACHES TO MARITAL AND FAMILY THERAPY

This article outlines the development of an interactive video system designed to demonstrate differential approaches to family therapy using identical therapy situations. The primary purpose of the project is to resolve some of the confusion many novice family therapists experience while being exposed to the numerous family therapy approaches. Technical aspects of the interactive video system are also outlined.