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Interactions between dentists and anxious child patients: a behavioral analysis.

The aim of this investigation was to study the effect of dentists' behavior on the (anxious) behavior of child patients. Twelve high-anxious and a matched group of 12 low-anxious children from 6 to 12 yr of age were selected and randomly assigned to one of six dentists: three with experience in treating fearful children and three without such experience. Each child was treated twice. The first treatment was prophylactic, the second, 2 wks later, consisted of preparation and restoration of a cavity (Class 1) under local anesthesia. While both treatment sessions were videotaped, only the latter one was used in this study. Data analysis which did not control for autocorrelations revealed 22 (out of 28) significant effects. Data analysis with a control for autocorrelations showed only two significant effects: 'working contact', which decreased fear-related behavior and 'no physical contact', which increased fear-related behavior.

Anxiety↗

International borders, ground water flow, and hydroschizophrenia.

A substantial body of research has been conducted on transboundary water, transboundary water law, and the mitigation of transboundary water conflict. However, most of this work has focused primarily on surface water supplies. While it is well understood that aquifers cross international boundaries and that the base flow of international river systems is often derived in part from ground water, transboundary ground water and surface water systems are usually managed under different regimes, resulting in what has been described as "hydroschizophrenia." Adding to the problem, the hydrologic relationships between surface and ground water supplies are only known at a reconnaissance level in even the most studied international basins, and thus even basic questions regarding the territorial sovereignty of ground water resources often remain unaddressed or even unasked. Despite the tensions inherent in the international setting, riparian nations have shown tremendous creativity in approaching regional development, often through preventive diplomacy, and the creation of "baskets of benefits," which allow for positive-sum, integrative allocations of joint gains. In contrast to the notion of imminent water wars, the history of hydropolitical relations worldwide has been overwhelmingly cooperative. Limited ground water management in the international arena, coupled with the fact that few states or countries regulate the use of ground water, begs the question: will international borders serve as boundaries for increased "flows" of hydrologic information and communication to maintain strategic aquifers, or will increased competition for shared ground water resources lead to the potential loss of strategic aquifers and "no flows" for both ground water users?

Conservation of Natural Resources↗

Team members' and supervisors' ratings of team performance: a case of inconsistency.

This study used measures of team performance, organizational support, and supervisors' judgment to examine the consistency of ratings of teams by both their members as well as their supervisors. For 75 team members from 13 different work teams in different organizations Pearson correlation coefficients were used to assess the consistency of ratings of these measures within the teams and between teams and supervisors. The results indicate the need for rater training, both at the team and supervisor levels.

Adult↗

Low-ball and compliance to a request: an application in a field setting.

The low-ball refers to a compliance technique in which a demand of someone to agree to a request is followed by telling the person the real cost of the request. The number of people who maintain their first decision is larger than the number in the condition in which the real cost of the request is stated prior to the initial compliance. Researches in this paradigm traditionally included a request addressed by a professor to students but was never tested between strangers. So, an experiment was carried out in which people were solicited to keep a dog (8 kg) on a lead until a male confederate returned from a visit to someone in a hospital. In low-ball condition, the confederate told the subject who agreed to the request that it would take 30 min., whereas in the control condition the confederate gave this information when stating his request. Analysis showed that low-ball technique leads people to maintain their first decision.

Adult↗

The feasibility of HLA matching for lung transplantation.

The benefits of HLA matching have been clearly demonstrated in renal and cardiac transplantation. Recent studies suggest that HLA matching may be associated with improved survival rates for transplantation as well. However, the effect of HLA matching for lung transplantation has not been clearly demonstrated. Despite the possible benefits of HLA compatibility, matching for lung transplantation is based solely on ABO compatibility and lung size. Several factors limit the feasibility of utilizing HLA matching for lung transplantation. Among these factors is the time required to perform HLA typing, to identify appropriate recipients, and to allocate lungs; an additional constraint is the urgent need for transplantation in patients experiencing rapid clinical decline. The obstacles to using prospective HLA matching for lung allocation are significant, and matching lung donors and recipients according to histocompatibility status would require considerable effort. However, with supra-regional cooperation among transplant centers and procurement agencies, it appears feasible to consider HLA matching for lung transplantation. Given the potential for improved survival, a project should be undertaken to determine the impact of HLA matching on the outcome of lung transplantation.

ABO Blood-Group System↗

Ethics, policy, and rare genetic disorders: the case of Gaucher disease in Israel.

Gaucher disease is a rare, chronic, ethnic-specific genetic disorder affecting Jews of Eastern European descent. It is extremely expensive to treat and presents difficult dilemmas for officials and patients in Israel where many patients live. First, high-cost, high-benefit, but low volume treatment for Gaucher creates severe allocation dilemmas for policy makers. Allocation policies driven by cost effectiveness, age, opportunity or need make it difficult to justify funding. Process oriented decision making based on terms of fair cooperation or decisions invoking the "rule of rescue" risk discriminating against minorities who may already suffer from inequitable distribution of heath care resources. Apart from cost, Gaucher disease prompts questions about abortion. Unlike severe genetic disorders, Gaucher offers no grounds for abortion and, in many ways, is analogous to gender based abortions that are prohibited regardless of fetal age. Finally, Gaucher raises concerns about the disclosure of genetic information. These affect potential carriers asked to participate in population studies and carriers and patients who must consider disclosure to others. These concerns weigh the right to privacy against communal interests and bilateral commitments.

Abortion, Induced↗