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Biomedical subjects

D M Baer

Publications and source records attributed to D M Baer.

At least 19 recordsLinked to original sources
PubMed1997

A use of self-instruction to extend the generalization of a self-instructed in-common discrimination.

Three typically developing preschool children were presented with an in-common sorting problem involving colored and marked shapes; the task was to see what two pictures had in common and to sort a deck of pictures according to that feature. The children failed to sort accurately. They were then taught to name the common features of any pair and to answer the question, "What are you looking for?" before sorting, to produce the form of a self-instruction (e.g., "I'm looking for blue triangles"). They still failed to sort accurately until they were taught to link their sorting to that potentially self-instructive answer. They then showed perfect accuracy in sorting and occasional spontaneous overt self-instructions, when told only, "Put here what these pictures have in common," across ever-changing pairs (much like the children of prior reports). The present report asks whether that finally correct performance would generalize to new stimuli. Accordingly, the children were probed with steadily changing sample pairs of three new stimulus sets-recombinations of the colored, marked shapes used in training; letters; and pictures. One child showed near-perfect generalization to all three of these new sets (like many children in prior reports). But the other two children showed near-perfect generalization to only two of the sets and not to the third Set-letters. Merely reintroducing the content-free question, "What are you looking for?" and acknowledging correct answers to it (i.e., self-instructions about letters) yielded largely accurate sorting of letter problems; this way of remediating failures of generalization had not been studied before. In general, sorting problems with two elements in common proved more difficult than those with one element in common; this difference diminished in the child told to self-instruct about letters after that self-instruction.

Child, Preschool↗
PubMed1997

Behavioral-medical treatment of pediatric toileting refusal.

Behavioral and medical treatments for toileting refusal (TR) were investigated using two additive treatments in a multiple-baseline design with 11 preschool-aged children. After Pretreatment A, Treatment B increased high-fiber foods and liquids, initiated mineral-oil therapy, and added positive reinforcement for appropriate toileting. After bowel clean-out, Treatment C induced daily bowel movements with suppositories and applied negative behavioral consequences for inappropriate toileting. Behaviors measured were appropriate and inappropriate bowel movements. Treatment B alone eliminated TR in three boys in 27 to 36 days and reduced the TR of one girl in 40 days. When indicated, Treatment B + C eliminated TR in two boys and four girls in 37 to 79 days and reduced the TR of one boy in 92 days. All 11 of the children were accident free and having at least one bowel movement every 2 days during 5 consecutive days of follow-up conducted 3 to 4 months after treatment. Parents reported general satisfaction with the treatment.

Behavior Therapy↗
PubMed1997

Behavioral cusps: a developmental and pragmatic concept for behavior analysis.

Most concepts of development explain certain behavior changes as products or markers of the invariable succession of emerging periods, stages, refinements, or achievements that define and order much of an individual's life. A different but comparable concept can be derived from the most basic mechanisms of behavior analysis, which are its environmental contingencies, and from its most basic strategy, which is to study behavior as its subject matter. From a behavior-analytic perspective, the most fundamental developmental questions are (a) whether these contingencies vary in any systematic way across the life span, and thus make behavior change in a correspondingly systematic way; (b) whether some of these contingencies and their changes have more far-reaching consequences than others, in terms of the importance to the organism and others, of the behavior classes they change. Certain behavior changes open the door to especially broad or especially important further behavior change, leading to the concept of the behavioral cusp. A behavioral cusp, then, is any behavior change that brings the organism's behavior into contact with new contingencies that have even more far-reaching consequences. Of all the environmental contingencies that change or maintain behavior, those that accomplish cusps are developmental. Behavior change remains the fundamental phenomenon of development for a behavior-analytic view; a cusp is a special instance of behavior change, a change crucial to what can come next.

Aptitude↗
PubMed1996

A task analysis of the shift from teacher instructions to self-instructions in performing an in-common task.

Three preschool children repeatedly did four kinds of sorts with a deck of stimulus cards: a difficult, untaught target sort and three other sorts considered analytic of self-instructing the target performance. The untaught target sort was to find in a deck of cards those matching what two sample cards had in common. Most preschool children must be taught to mediate this problem. The three other kinds of sorts taught skills involved in the target performance or its mediation. As correct self-instructive talk emerged in the target sorts, it was confirmed. The untaught target sorts were interspersed infrequently among the three alternating directly taught skill sorts, to see if accurate target sorts, and accurate self-instructive talk about the target sorts, would emerge as the three skill sorts were mastered. As all the sorts progressed, increasing accuracy was seen first in the skill sorts and then in the untaught target sorts. All three subjects showed subsequent generalization to new target sorts involving other stimulus sets. Correct spontaneous self-instructions about the target sorts increased from near zero at the beginning of the experiment to consistency at its end. Thus the three skill sorts appeared sufficient for the emergence of a self-instructed solution to the previously insoluble target performance.

Child, Preschool↗
PubMed1995

Characterization of a recombinant that locates the hereditary hemochromatosis gene telomeric to HLA-F.

The gene responsible for hereditary hemochromatosis has been shown to be closely linked to the HLA-A and D6S105 loci on the short arm of chromosome 6. Efforts at mapping the disease gene have been hindered, however, by a lack of informative recombinant in this region. We have identified two recombinant individuals in a single affected family and have confirmed recombination by analysis of 16 polymorphic markers located near HLA-A and D6S105. One of the recombinants provides evidence for the location of the hemochromatosis gene telomeric to HLA-F.

Adult↗
PubMed1995

Hemochromatosis screening in asymptomatic ambulatory men 30 years of age and older.

OBJECTIVE: To perform a cost-benefit analysis of screening for hereditary hemochromatosis. PATIENTS AND METHODS: A total of 3,977 consecutive men > or = 30 years of age who presented for routine health checkups at a health maintenance organization medical center were screened for hereditary hemochromatosis by measuring transferrin saturation. Subjects with repeated transferrin saturation > or = 62% and ferritin level > or = 500 ng/mL (> or = 500 micrograms/L) were referred for liver biopsy. Subjects with transferrin saturation < 15% were referred for evaluation. Laboratory testing, screening, and abnormal screening test evaluation procedures were identified by chart review. RESULTS: Forty patients had transferrin saturation > or = 62%. One hundred seventy-two had transferrin saturation < 15%. Eight patients with hemochromatosis were identified. The 3 patients most seriously affected had hepatic iron concentrations > 250 mumol/g dry weight. Two of them had hepatic fibrosis. Seven cases of hemochromatosis were found among 1,974 white subjects who were screened. Only 1 case was found among the remaining subjects. CONCLUSIONS: Our observations support routine screening with transferrin saturation for white men > or = 30 years of age.

Adult↗
PubMed1995

On-line computer pharmacokinetics program: lessons learned from its failure.

Decision support computer technology (DST) embedded in laboratory or hospital information systems has great potential but has rarely been successful. Through studying a pharmacokinetic program that automatically extracted data without requiring manual data entry, we have identified several barriers to the successful implementation of DST. Manual data entry is a major barrier, but so is the entry of erroneous data such as heights, weights, drug dosing times, and specimen collection times. In such a system, unanticipated changed modes of clinical practice and software changes in the system's component modules can be incompatible with the decision-support program, necessitating software revisions. We also noted that clinicians increased their ordering of laboratory tests and changes in drug doses but without improvement in patients' outcomes. This suggests that information output from the program can be misinterpreted by clinicians. In summary, DST programs should be validated in an actual working environment.

Aminoglycosides↗
PubMed1994

The effects of self-instruction on preschool children's sorting of generalized in-common tasks.

Three normal preschool children were presented with a sorting task ordinarily insoluble by 4-year-olds, based on the visual discrimination of what features two sample stimuli had in common. Failing to sort correctly according to that criterion, they were then presented with task-analytic conditions in which they learned to name correctly the common features of pairs of such stimuli and to sort correctly according to experimenter-named common attributes. This proved insufficient in producing correct sorting, even when the children were asked to name what the stimuli had in common and did so correctly just before they were asked to sort. The children were then asked to self-instruct: The experimenter said, "So, what are you looking for?" just before the children began to sort in response to the experimenter's presentation of two sample stimuli. This condition typically yielded correct answers to the question and correct sorting, which proved reversible if the experimenter discontinued the question or asked the child to not ask or answer what the two stimuli had in common, just before sorting. The self-instructional effect was found to generalize to new sets of visual stimuli and to a novel experimenter.

Child Development↗
PubMed1994

Iron stores are not associated with acute myocardial infarction.

BACKGROUND: This study evaluated the relation between body iron stores and coronary artery disease. It has been suggested that total body iron stores are an independent risk factor for acute myocardial infarction (AMI). METHODS AND RESULTS: Our study population consisted of 46,932 members of a prepaid health plan who were > or = 30 years old and who received a standard health check between 1969 and 1971. Blood collected during this examination was analyzed for serum iron and total iron-binding capacity. Transferrin saturation (TS), calculated as (serum iron/total iron-binding capacity) x 100, was categorized as low (< or = 10%), normal (11% to 61%), or elevated (> or = 62%). Hospital stays for AMI were identified from the health plan's computerized discharge records for its Northern California Region through December 31, 1991. Mean follow-up time was 14.1 years. During the follow-up period, 969 men and 871 women had an AMI-related hospital stay. Analysis of AMI-related hospital stays was performed overall and by sex. Age-adjusted incidence rates were obtained for each TS level, and proportional hazards regression models were used to assess the significance of TS as a risk factor for AMI, controlling for other known coronary disease risk factors. Our results did not show iron deficiency as defined by low TS to be protective against AMI. Subjects with increased iron stores indicated by TS > or = 62% had a relative risk for AMI of 1.3, which was not statistically significant. CONCLUSIONS: Our observations do not support the hypothesis that coronary artery disease risk is related to iron stores.

Adult↗
PubMed1993

Programming generalization of in-class transition skills: teaching preschoolers with developmental delays to self-assess and recruit contingent teacher praise.

We investigated a self-management intervention package that taught preschoolers with developmental delays to self-assess performance of targeted skills and to recruit teacher praise. Self-assessment alone resulted in increases in active engagement across all participants during the training sessions, but generalization to classrooms was sporadic and short-lived. When recruitment of contingent praise was added to the training package, treatment effects generalized to the participants' classrooms and teachers' rates of contingent praise increased. The implications of combining self-assessment and recruitment of contingent teacher praise are discussed.

Awareness↗