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Biomedical subjects

D M Baer

Publications and source records attributed to D M Baer.

At least 55 records · Page 3Linked to original sources
PubMed1989

A developmental analysis of rule-following.

The development of rule-governed behavior begins when a class of verbal forms called instructions, in conjunction with other variables, systematically occasion functional consequences for compliance (or noncompliance). These instructional forms then function as specific stimulus controls for compliance, with the other variables potentially taking on conjoint or conditional stimulus control of that compliance. Experience with numerous instructions occasioning functional consequences for compliance can establish generalized compliance to an indefinitely large stimulus class of instructions, a stimulus class that readily and naturally includes those forms that describe relationships between events and response to them that we also call rules. The important conjoint variables may well be the instruction giver (rule stater), any of their other systematic characteristics that have occasioned functional consequences for compliance in the past, and the topography of the response requested. Generalization of compliance across people, settings, and topography can occur; this generalization can extend to self-instruction, and can fail to extend to certain topographies ("Thou shalt not kill"), certain rule staters (nonpeers who say "Don't use drugs" when peers say it is fun), and certain settings ("Don't play with John in class"). Finally, children's experiences with describing behavior can lead to new self-instructions that fit the already established discriminative-stimulus class of rules and instructions for compliance, so that the novel self-instruction produces compliance. Compliance-oriented research has demonstrated how instruction givers can establish instructions as a discriminative-stimulus class for compliance, and how generalized compliance to new instructions and new instruction givers can be accomplished. Correspondence-training research has demonstrated that self-instructions can become discriminative for later performance of the described behaviors. Self-instruction research suggests that these forms of instructions also can control subsequent behavior, and that instructions and rules may be produced covertly as well as overtly. What has yet to be demonstrated is an ability to produce a novel self-instruction that controls subsequent behavior. The argument has been that the development of a behavior class, compliance to instructions, could provide a reasonable explanation for the acquisition of rule-governed behavior. Experiences within the natural environment, as well as research on compliance, correspondence, and self-instruction, suggest that a behavior class, compliance to instructions, could provide a reasonable model of the acquisition and ge

Behaviorism↗
PubMed1989

Interaction effects in multielement designs: inevitable, desirable, and ignorable.

A single-subject design often used to compare the effectiveness of two or more independent variables (like treatment programs) is the multielement (alternating treatments or simultaneous treatments) design. Variants of this design approximate the concurrent comparison of the effects of two or more variables (or levels of variables) by programming the variables (or levels) in rapid alternation, typically across or within daily sessions. Properly combined with conventional reversal designs, these designs can also display a variety of interaction effects, some of them worrisome, others highly desirable for the future development of the field. A worrisome model is the possibility that when Treatment B alternates rapidly with Treatment C, the effects of each will not be the same as when each is the only treatment used. A desirable model is the use of the multielement design as a fast-paced component of an otherwise conventional reversal design examining contextual control of some relationship; the possibility that some behavior responds differently to Controlling Variables A and B in Context X than in Context Y. This second possibility opens single-subject designs to the more efficient examination of all interactive effects and is highly desirable, considering the prevalence and importance of interactions in determining the limits and the generality of currently understood behavioral phenomena.

Behavior Therapy↗
PubMed1987

Managing bedside glucose testing in the hospital.

The scope and magnitude of bedside testing by personnel without formal laboratory training have recently increased. There has been some question about the reliability of bedside test results produced by nurses, physicians, and other ward staff that are used in clinical decisions. Glucose testing is currently the most widely performed bedside test. Because of the likelihood that the use of bedside testing will increase in the future, this article discusses various issues concerning bedside glucose analysis, including the scope of such testing, staff responsibilities, training and supervision, testing frequency, work flow and result reporting, and the reliability of bedside glucose results, in three institutions. We also suggest an approach to bedside testing quality management.

Blood Glucose↗
PubMed1987

Evaluation of a laboratory system intended for use in physicians' offices. I. Reliability of results produced by trained laboratory technologists.

The accuracy and precision of the Kodak DT-60 tabletop chemistry analyzer were evaluated in the clinical laboratory at the Portland (Ore) Veterans Administration Medical Center, and its operational throughout and cost were estimated. All DT-60 tests that were studied exhibited clinically acceptable precision and, except for the glucose method, accuracy. The accuracy of the glucose method was indeterminate with the available data. Throughput under field conditions was found to be less than half of the manufacturer's claim. The estimated supply cost per test could vary from $1.20 to $5.49 per test, depending on the test type and the number of assays expected to be performed daily. The instrument seems to be accurate, precise, and generally reliable when operated by professional medical technologists.

Autoanalysis↗
PubMed1987

Evaluation of a laboratory system intended for use in physicians' offices. II. Reliability of results produced by health care workers without formal or professional laboratory training.

The Kodak DT-60 tabletop chemistry analyzer was evaluated with standardized protocols to determine the system's precision and accuracy when operated by four volunteers (a secretary, a licensed practical nurse, and two family medicine residents) in a simulated office laboratory. The variability of the results was found to be significantly greater than the variability of results produced by medical technologists who analyzed the same samples during the same study period with another DT-60 placed in the hospital laboratory. The source(s) of increased variance needs to be identified so the system can be modified or new control procedures can be developed to ensure the reliability of results used in patient care. Prospective purchasers, manufacturers, and patients need this kind of objective information about the reliability of results produced by systems intended for use in physicians' office laboratories.

Autoanalysis↗
PubMed1987

The effect of hyperlipidemia on therapeutic drug assays.

Hyperlipidemia interferes with spectrophotometric assays of a number of analytes. No interference was found in the assay of gentamicin, phenytoin, or phenobarbital due to turbidity in levels of triglyceride less than or equal to 2,000 mg/dl with the Abbott TDx or Syva enzyme multiplied immunoassay (EMIT) methods. There is no evidence that lipophilic drugs partition into the lipid phase in severely hyperlipidemic serum. No assay errors due to turbidity or partitioning of phenobarbital in the lipid of serum with a triglyceride concentration of 10,000 mg/dl were found, nor were changes seen in free phenytoin distribution due to hyperlipidemia.

Fluorescence Polarization↗
PubMed1987

Some still-current dimensions of applied behavior analysis.

Twenty years ago, an anthropological note described the current dimensions of applied behavior analysis as it was prescribed and practiced in 1968: It was, or ought to become, applied, behavioral, analytic, technological, conceptual, effective, and capable of appropriately generalized outcomes. A similar anthropological note today finds the same dimensions still prescriptive, and to an increasing extent, descriptive. Several new tactics have become evident, however, some in the realm of conceptual analysis, some in the sociological status of the discipline, and some in its understanding of the necessary systemic nature of any applied discipline that is to operate in the domain of important human behaviors.

Journal Article↗