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B Duncan

Publications and source records attributed to B Duncan.

100 records · Page 6Linked to original sources

Choice for periodic schedules of reinforcement.

Pigeons' responses in the presence of two concurrently available (initial-link) stimuli produced one of two different (terminal-link) stimuli according to identical but independent variable-interval schedules. Responding in the mutually exclusive terminal links was reinforced with food according to fixed-ratio schedules for six pigeons and according to fixed-interval schedules for two pigeons. None of the pigeons matched the proportion of (choice) responses in the initial links to the proportion of the rates of reinforcement obtained during the terminal links. Instead, as the values of each of the terminal-link schedules were increased by a constant amount, the choice proportions for the stimulus associated with the smaller of the two values increased, even though the relative rates of reinforcement during the terminal links decreased. These results are incompatible with those from previous studies with aperiodic (variable-interval or variable-ratio) schedules. The present results do suggest, however, that in transforming aperiodic schedules into their periodic equivalents, it may be necessary to consider the size of the smallest interreinforcement interval comprising the terminal-link schedules.

Journal Article↗

Evaluation of an alternative model of anticoagulant care.

BACKGROUND: Alternative models for the delivery of anticoagulant care are required in view of an estimated increase of 20% per annum in patients requiring treatment, and an inability for the present service to deal with this increase. This led to a restructuring of the anticoagulant service, which included the appointment of a nurse specialist and the implementation of a computer-assisted warfarin dosing system. AIM: To assess the impact of changes in the delivery of anticoagulant care in one unit. METHODS: A previous consultant-led delivery service of anticoagulant care was compared with the current nurse-led service. Two six month periods was compared. The end points of the study were INR control, appointment intervals and clinic size. A patient questionnaire was completed to assess patient satisfaction and education. RESULTS: In two years, attendance at walk-in clinics increased by 43% but the number attending anticoagulant clinics decreased by 50%. There was a parallel increase in the number of patients presenting on a flexible 'walk-in' basis for phlebotomy with postal dosing with 76% of patients now being managed on a flexible postal system. Anticoagulant control and reattendance intervals compare favourably, the percentage of patients attending at the maximal reattendance interval of eight weeks has increased from 3% to 15%. Patient knowledge and satisfaction scores were high on the questionnaire. Financially, this model of care is more cost effective than employing further doctors. CONCLUSION: The introduction of a nurse specialist managed service has allowed us to accommodate a 21% annual increase in patient numbers while improving the overall quality, efficiency and cost-effectiveness of the service and patient care.

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