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PubMedDate not supplied

[Legal basis for ontogenetic sex judgment in sex disapproval syndrome in the form of transsexualism. Comparison of the situation in Poland and in some other countries].

Sex disapproval syndrome in the form of transsexualism is characterized by incompatibility of biological and psychically-emotional sex. This incompatibility leads to a discrepancy between one's social role and his or her biological sex. The aim of this paper is to present and compare the legal basis for ontogenetic sex judgment in the sex disapproval syndrome in the form of transsexualism in Poland and in some other countries. Poland, contrary to some other countries, does not have any appropriate legislation for determining the above issue. So far all judgment has been based on exponential activities, in anticipation for the so called transsexual act. This act may be created on the basis of existing legislation in other European countries, which is briefly presented in the work.

Europe↗
PubMed1993

Athletic trainers' attitudes and judgments of injured athletes' rehabilitation adherence.

Certified athletic trainers (ATCs) in District 2 (n=187) of the National Athletic Trainers' Association (NATA) were asked to complete a questionnaire that assessed the attitudes and judgments of ATCs concerning numerous factors presumed to influence sport injury rehabilitation. Gender and experience differences in ATCs' attitudes and judgments about rehabilitation adherence were examined. Successful and unsuccessful adherence strategies also were reported. The questionnaire consisted of 60 statements that were categorized into seven scales: athletic trainer's influence, environmental influences, athlete's personality, pain tolerance, selfmotivation, goals and incentives, and significant others. There were no significant differences for either gender or experience of ATCs on any of the seven scales. An analysis of questionnaire item responses revealed the following as factors ATCs deemed important to injury rehabilitation: a) good rapport and communication between the ATC and the injured athlete, b) explanation of the injury and rehabilitation regimen, c) convenience and accessibility of the rehabilitation facility, d) rehabilitation sessions planned around the athletes' busy schedules, e) athletes' beliefs that the program is worth pursuing, f) personal supervision and regular monitoring, g) need for injured athletes to see immediate results, and h) support from significant others. ATCs reported education, goal setting, encouragement, monitoring progress, and support systems as successful strategies. Threats and rehabilitation without monitoring were reported as unsuccessful strategies.

Journal Article↗
PubMed1990

Consonant recognition and quality judgments of noise-reduction hearing aids.

We evaluated seven different hearing aids worn by 13 experienced hearing-aid users. Two of the aids, the Audiotone A-54 and the Telex 363C, included amplitude compression. The others, two versions of a Maico aid (SP147), a Richards (ASE-B), a Rion (HB-69AS), and a Siemens (283ASP), have circuits designed to attenuate specific frequency regions in the presence of noise. Consonant recognition and quality judgments were measured with the processing circuit on and off in the presence of speech-babble noise and low-frequency noise. The results suggested that only a few subjects benefited from the processing circuits. Quality judgments and consonant recognition scores were not always in agreement.

Hearing Aids↗
PubMed1989

Pleural effusion: comparison of clinical judgment and Light's criteria in determining the cause.

Pleural fluid analysis is often the initial diagnostic test used to determine the cause of a pleural effusion. We prospectively studied 33 consecutive patients with pleural effusions to determine whether the fluid arose from a transudative or an exudative process. Clinical judgment by an internist before thoracentesis and both serum and pleural fluid protein and lactic dehydrogenase levels (commonly referred to as "Light's criteria") were compared to the patient's final diagnosis. The internist correctly classified 15 of 17 exudative processes and all 16 transudative processes; the presence of any one of Light's three criteria correctly classified 15 of 17 exudative processes, whereas the absence of all three criteria correctly classified 14 of 16 transudative processes. Clinical judgment and Light's criteria are comparable in their ability to predict whether an exudative or transudative process was responsible for the effusion. Both methods are associated with errors, though of different kinds; these errors occurred infrequently. Recognizing the limitations of these methods will permit the most accurate effusion categorization.

Aged↗
PubMed1979

A study of relationships between judgments of speech and appearance of patients with orofacial clefts.

A series of six studies was designed to examine the effects of subjects' appearance on listeners' judgments of nasal speech and to examine the effects of nasal speech on viewers' judgments of attractiveness. In three studies, pictures of male and female subjects with varying degrees of orofacial clefts were paired with tape-recorded speech samples with varying degrees of nasality, and judges rated speech acceptability. Results of two-way analysis of variance failed to support the idea that appearance has an effect on ratings of nasality. In three other studies, the same stimuli were used to examine the effects of nasal speech on judges' ratings of appearance. Results of a two-way analysis of variance indicated that nasality had an effect on ratings of appearance. As the severity of nasality increased, ratings of attractiveness decreased. Results imply that a decrease in nasality may enhance the way persons with cleft lips are perceived cosmetically.

Cleft Lip↗
PubMed1988

Comparison of clinical judgment, Doppler ultrasound, and fluorescein fluorescence as methods for predicting intestinal viability in the pony.

Strangulation obstruction was induced in anesthetized ponies for periods of 2 and 3 hours by clamping 45-cm segments of jejunum and associated veins (venous strangulation obstruction) and arteries and veins (arterial and venous strangulation obstruction). Four segments were studied in each of 7 ponies allowed to survive 12 hours, 2 segments in a pony that was allowed to survive 1 hour, and 1 segment in each of 10 ponies allowed to survive 42 days after the strangulation periods ended. Fifteen minutes after the periods of strangulation obstruction ended, the viability of test segments was assessed by clinical judgment (40 segments), fluorescein fluorescence (40 segments), and Doppler ultrasound (32 segments). Because the test segments were normal at necropsy in long-term survivors, all segments were designated as viable. The overall accuracy of the methods used to predict viability was 88% for Doppler ultrasound and 53% each for clinical judgment and fluorescein fluorescence (P less than 0.005). Failures in the last 2 techniques could be attributed to their tendency to score venous strangulation obstruction segments as nonviable (90% for each). Doppler ultrasound was 94% accurate in these segments.

Animals↗
PubMed1987

[Disorders of the diagnostic judgment process in pre-oedipal pathologies].

The processual and argumentative treatment of diagnostic data that characterizes the development of a psychoanalytic judgment appears to be subject to frequent disturbance in cases of pre-oedipal pathologies. Partly as a result of the strong resistance and refusal patterns of such patients, the psychoanalyst neglects to subject to critical analysis his own expectations of progression and his own standards of judgment. In addition, he often makes an effort to protect himself from the sado-masochistic offers of interaction of these patients. If the transference relationship represents the field on which the spectrum of the neurotic patient's relationships is to be redefined, the point of psychoanalytic treatment in cases of pre-oedipal pathologies is to provide the patient with a "playground" on which the rift between the infantile experience of insatiable drives and needs on the one hand and the world of social action perceived as empty, lifeless, and alien on the other can be played out and overcome.

Drive↗
PubMed1987

Social judgments of facial deformity.

The purpose of this study was to examine age- and gender-related personality and ability judgments associated with facial deformity. Four age groups (range = 8 to 16 years) were shown either photographically corrected versions of children with congenital facial clefts or uncorrected versions. Subjects' ratings of photographs of children with facial deformity were consistently negative. Neither age nor gender of subject were significantly related to judgments of facial deformity. Pictures of girls with facial deformities were judged more negatively than pictures of boys. The implications of these findings for future research were discussed.

Adolescent↗
PubMed1987

Functional assessment of the elderly. A comparison of standard instruments with clinical judgment.

Using specific instruments and scales to measure mental status, nutritional state, visual acuity, gait, and activities of daily living, we studied 79 medical inpatients aged 70 years or older. We then interviewed the patients' primary physicians and nurses and asked them to rate their patients. The prevalence of functional impairment was high: 25 (32%) of the 79 patients were mentally impaired, 31 (39%) were malnourished, 18 (23%) were visually impaired, 31 (39%) had impaired gait, and 23 (29%) had problems with continence. Although clinicians recognized severe impairments, the sensitivity of their clinical judgment was poor in detecting moderate impairment in four categories: mental status sensitivity was 28% (5/18); nutrition, 54% (14/26); vision, 27% (4/15); and continence, 42% (5/12). With clinical judgment alone, physicians and nurses correctly identify severe impairment, but the more prevalent moderate impairments in mental status, nutrition, vision, and continence are poorly recognized. Comprehensive functional assessment instruments can detect these moderate impairments, which may be remediable through early intervention.

Activities of Daily Living↗
PubMed1980

A comparison of transverse and vertical pharyngeal flaps using electromyography and judgments of nasality.

Previous studies have reported less than adequate speech results for vertical types of pharyngeal flaps with some patients. However, no controlled judgments of nasality have been reported for transverse pharyngeal flaps, and no comparative studies have been done. In this investigation, 21 listeners evaluated nasality in two groups of seven cleft palate patients. One group had had vertical pharyngeal flaps, while the other group had had transverse pharyngeal flaps. The possible relationship of observable electromyographic activity to nasality was also studied. The results indicated that perceptual ratings of postoperative speech in the two groups did not differ significantly. Also, because similar muscle action potentials were observed in both types of pharyngeal flaps, it was concluded that this activity was not a contributing factor in the judgments of nasality.

Child↗
PubMed1980

Perceptual isolation and position judgment.

Prior findings showed that perceptual isolation of one item in a low similarity list facilitated total-list learning of order. A reconstruction procedure in which a spatial framework was provided during test trials, was used in those studies. In order to extend the generality of those findings, a position judgment procedure was used in the present experiments; subjects estimated ordinal position of each item following each of six study trials in which the 12 CVC items were displayed in a fixed sequence. That to-be-learned sequence was defined temporally in Experiment 1, which failed to corroborate prior findings, but was presented simultaneously and spatially in Experiment 2, which did. Interpretation focused on conditions necessary for finding homologous effects for supplied anchors and isolating stimuli, suggesting that absolute judgment can be regarded as a special case of serial learning, and vice versa, and on circumstances allowing utilization of an isolating stimulus as an organizational device.

Humans↗
PubMed1981

[An analysis of the "same-different" judgment process in the color and form multidimensional stimulus (author's transl)].

The "same-different" judgment process was investigated using the colon and form multidimensional stimuli. "Same-different" reaction time paradigm was employed in which the stimulus was sequentially presented. Exp. I was designed to clarify the processing mechanism of the "different" judgment. The results suggested that the "different" response was initiated by the processing of each dimension. In Exp. II, the dimensions of the first stimulus were separated and sequentially presented. It was found that the RT for the separated presentation was shorter than that for the composed presentation in Exp. I. The results suggested that the hypothesis of parallel matching based on dimensions was enough to explain the RT of the "same" response. Based on the results of Exp. I and Exp. II, the sequential-dual process model was proposed.

Color Perception↗
PubMed1980

Rationing of medical care and the preservation of clinical judgment.

It is inevitable that efforts to contain medical care costs will increase. Approaches to cost containment vary substantially and have different effects on access, equity, and professional performance. Cost sharing primarily affects the behavior of patients, while other types of regulation are intended to influence how physicians practice. While some types of physician regulation such as prospective budgeting are intended to constrain physician decision making without dictating clinical judgment, other approaches are more intrusive on physician autonomy. Physicians should contribute to the development of regulatory approaches consistent with the responsible exercise of clinical judgment and professional autonomy.

Cost Control↗
PubMed1996

Clinical judgment and management of postoperative pain in critical care patients.

BACKGROUND: Acute pain is a significant problem in critical care patients. Although many barriers to successful assessment and management of pain in critical care patients have been noted, little is known about how critical care nurses make clinical judgments when assessing and managing patients' pain. OBJECTIVE: This qualitative analysis is part of a pilot study evaluating nurses' use of a pain assessment and intervention notation algorithm in patients in critical care areas who have limited communication abilities after abdominal or thoracic surgery. METHOD: Transcribed audiotapes of nurse participants' "thinking aloud" while using the pain assessment and intervention notation algorithm were analyzed by using interpretive phenomenology. The interpretive account is based on 31 tape recordings of 14 nurses caring for 41 patients (12 patients in the ICU and 29 patients in the postanesthesia care unit). FINDINGS: The two domains of clinical judgment found were (1) assessing the patient and (2) balancing interventions. CONCLUSIONS: Many nurses' reports showed that they accurately assessed their patients' needs for analgesics. Through testing of and learning from their patients' responses, nurses were able to give amounts of analgesics that diminished patients' postoperative pain. Additionally, nurses had to balance analgesic administration against the patients' hemodynamic and respiratory conditions, medical plan and prescriptions, and the desires of the patients and the patients' families.

Adult↗
PubMed1996

Unconscious Gender Bias in Fame Judgments?

In two experiments the conditions of, and the processes leading to, gender biases in fame judgments were investigated. In Experiment 1, the gender bias was not reduced in a condition that alerted participants to the gender of the names. In Experiment 2, participants' sex-role orientation, but not their gender, was related to the gender bias. The process dissociation procedure was used in both experiments in an attempt to separate conscious and unconscious memory processes contributing to the gender bias. Using L. L. Jacoby's (1991) original measurement model there appeared to be evidence for unconscious influences on the gender bias in fame judgments. Unfortunately, this evidence disappeared when a model was used that takes guessing and, hence, response biases into account, which confirms that measurement models that ignore response biases in the process dissociation procedure may lead to erroneous conclusions.

Journal Article↗
PubMed1997

Comparison of clinical judgment and diagnostic ultrasonography in the diagnosis of acute appendicitis: experience with a score-aided diagnosis.

OBJECTIVE: To evaluate the diagnostic accuracy of clinical judgment and diagnostic ultrasonography (US) used routinely and to create a scoring system to aid diagnosis. DESIGN: Prospective, double-blind study. SETTING: University hospital, Denmark. SUBJECTS: 222 Consecutive patients suspected of having acute appendicitis admitted between 0800 and midnight from June 1990 to June 1992. INTERVENTIONS: 148 Patients (67%) underwent appendicectomy and the remaining 74 patients were observed. 193 Patients (87%) had a diagnostic US examination. 21 Predictive variables were collected prospectively to create a scoring system. MAIN OUTCOME MEASURES: Results of surgical pathological findings, clinical outcome (observed group), diagnostic US, and values of diagnostic score. RESULTS: The decision to operate was made by a junior surgeon solely on the clinical examination, which yielded a diagnostic accuracy of 76%, specificity of 58%, and negative appendicectomy rate of 36%. 193 Patients underwent diagnostic US conducted by the radiologist on call of whom 123 were operated on, 78 for histologically proven appendicitis. US had a diagnostic accuracy of 72%, sensitivity of 49%, and specificity of 88%. Of the 21 predictive factors for acute appendicitis 11 were significant (p < 0.05): total white cell count (WCC) (>10 x 10[9]/1), migration of pain to the right lower quadrant, gradual onset of pain, increasing intensity of pain, pain aggravated by movement, pain aggravated by coughing, anorexia, vomiting, indirect tenderness (Rovsing's sign), muscle spasm, and sex. These 11 predictors were assigned an appropriate weight, based on the likelihood ratio, and used to create a scoring system. The score performed poorly if it was used to separate patients for observation and those for appendicectomy. However, if the score was used with two cut-off points resulting in three test zones (low, intermediate, and high risk of having acute appendicitis), some diagnostic benefit was seen for those patients within the zones of high and low probability. CONCLUSION: The clinical judgment of a junior surgeon was disappointing, and diagnostic aids are desirable to reduce the negative appendicectomy rate. Diagnostic US performed poorly as a routine procedure. Application of an up to date scoring system might be of some help to patients with a high or low probability of acute appendicitis, but any conclusion about its clinical application cannot be drawn from this study.

Acute Disease↗
PubMed1996

A "thinking-in-action" approach to teaching clinical judgment: a classroom innovation for acute care advanced practice nurses.

The complexity of the evolving advanced practice nurse (APN) role demands new teaching strategies. Based on the challenges that clinicians face daily, we have developed a teaching-learning strategy that addresses five central issues: (a) learning to perceive or identify relevant clinical problems; (b) learning to address the limits of formalism by situating clinical problem solving according to the most relevant goals and intents; (c) learning to reason in transition about the particular clinical situation; (d) learning the ethical skill of problem engagement and interpersonal involvement; and (e) learning to take a stand as a responsible agent by making clinical judgments, acting on them, and advocating for the patient/family. Although these five central issues are typically excluded from classic academic approaches, they are addressed in the "Thinking-in-Action" approach. This teaching-learning strategy offers a different way of teaching clinical judgment that closely resembles the way in which expert nurses actually think and reason in patient situations as they unfold.

Decision Making↗
PubMed1998

[Effect of motor perceptions on affective judgment of attractive and unattractive portraits].

Two experiments are reported that investigate the influence of motor components of approach versus avoidance behavior on the evaluation of attractive versus unattractive photographs of persons. On the basis of prior body feedback research (Cacioppo, Priester & Berntson, 1993) it could be shown that approach behavior (arm flexion) leads to more positive evaluations than avoidance behavior (arm extension). This effect was obtained for online judgments as well as memory based judgments. Additionally, in Experiment 1, the influence of arm position was more pronounced, when arm position and photograph shared the same valence (arm flexion and attractive photos and arm extension and unattractive photos), whereas no influence on evaluation was observed when the valence of arm position and photograph was unshared (arm flexion and unattractive photos and arm extension and attractive photos). However, in Experiment 2, these results could only be replicated for attractive portraits, whereas for unattractive portraits both arm flexion and arm extension led to lower ratings compared to a control group. The results are discussed within the framework of a proposed contingency model that in general predicts body feedback effects only in the case of compatibility between the valence of expression and information. Furthermore, in Experiment 2 some evidence was obtained that qualifies that effect as automatic, inasmuch as increased distraction from evaluating the photographs bolstered the effect.

Adult↗