The named nurse. Let's name names.
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BACKGROUND: Opinions are frequently expressed in the medical literature whether patients should be addressed by their first or last names, but few supportive data are available. Our objective was to determine the preferences of a sample of ambulatory patients to guide physicians and other professionals in addressing their patients appropriately. METHODS: Three hundred seventy-five patients in a variety of ambulatory settings were asked how they wished to be addressed by physicians in various contexts. RESULTS: When meeting a physician for the first time, 45 percent of the respondents wanted to be called by their first names, 29 percent preferred last names, and 26 percent found either approach acceptable. When being addressed by a physician with whom they were already well acquainted, 78 percent favored given names, and only 6 percent chose surnames. Preferences varied little with age of the patient or with age or sex of the physician. CONCLUSIONS: These data indicate that one cannot predict reliably how a new patient will prefer to be addressed but that the great majority of established patients will want to be called by their first names.
By applying to given names formulations for analyzing the genetics of surname distributions, under certain assumptions one can separate the genetic components from the cultural components of surname distributions. Geographic distributions of surnames regularly yield larger coefficients of relationship or kinship within local populations than between them: for instance, Ri = 75 x 10(-5) within a local area in England but the Ri of those villages with all of England and Wales is 42 x 10(-5). On the contrary, the first names in an English and Welsh sample give essentially the same pseudocoefficient (based on first names) within registration districts (Ri = 354 x 10(-5) as between districts (Ri = 370 x 10(-5). Thus the decrease with distance of the coefficients based on surnames can be ascribed to the genetic component according to the Malécot principle, assuming that the first names are chosen in the same way as the surnames originated and consequently that the cultural component of surname distributions is no more localized than the distribution of given names (in this sample not at all).
By systematic training, 14 psychogeriatric patients (aged 70 to 95 years and admitted to day care because of dementia) were taught the first names of 8 members of staff of the day care center. Treatment duration was one month, twice weekly. The therapist introduced the names by a step-by-step approach, beginning with two name-face combinations, and adding one new name (and photograph of that person's face) every next training session. Treatment consisted of a combination of several cognitive strategies: organisation and directed attention, rehearsal, first letter cueing and vanishing cue techniques, and paired-associate learning based on rhymes, pictures and visual imagery. Patients were assigned at random to a treatment and a control group (waiting list condition). Patients in the control group received their training after the waiting period of one month. Using this pretest-posttest-control-group design, we were able to objectively evaluate treatment effects. Treatment caused a significant enhancement of knowledge of staff members names. Gains achieved using this program persisted over at least one month, as could be demonstrated by a follow-up evaluation.
Rowe and Stone dispose of descriptive terminologies for retinal units as 'essentialist' and argue for a 'neutral' multifactorial system redefined from previous W, X. Y nomenclatures. It is argued here that descriptive terminology need not be either essentialist or undesirable and that the W, X, Y terminology is too confused with false associations to be satisfactory. The synthetic power of the W, X, Y nomenclature was lost with the discovery of concentric W cell receptive fields, the projection of the W cells to the LGN and the suggestion of overlap between X and W conduction velocity groups. It was made methodologically unsound by its employment for the naming of Nissl stained soma classes before the identity of individual somas with the physiological entities can be demonstrated. Although now redefined, the identity of symbols in the several vintages of the W, X, Y system leads to inevitable confusion. The current tripartite division of a multidimensional quality space without cluster analysis is not neutral because it emphasises conduction velocity but represses the diversity of W receptive fields. The concise, apt and memorable descriptive receptive field terminologies are more desirable in that they are operationally based and approximate the unit's transfer function--the parameter most significant to the central nervous system in its information processing task; thus they are more suited for cross species comparison because of a probably bountiful source of functional hypotheses. The lack of taxonomic neutrality in the W, X, Y system has recently been emphasised by its failure to adequately classify rabbit retinal receptive field categories.
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Many schemes of ganglion cell classification seek to classify the cells by some particular characteristic, such as the time course of the cells' physiological responses or their dendritic morphology. It is here argued that such schemes are based on the Aristotelian concept of "essences" and raise the same difficulties as have arisen with the essentialist approach to animal taxonomy. A better approach to the classification of neurones, it is proposed, is to base the classification on as many features of the cells as possible, and to regard the classification as an hypothesis, subject to testing and modification by experience, about the "functional niches" occupied by the cell types distinguished.
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On pretests, 3 men with brain injuries matched dictated names of three therapists to written names, but did not match dictated or written names to photos, produce correct names in response to photos, locate offices given written names, or name therapists on sight. Match-to-sample training established conditional relations between dictated names and photos. Posttests showed the emergence of untrained conditional relations involving photos and written names, indicating development of three classes of equivalent stimuli (each containing a dictated name, photo, and written name). For 1 participant, conditional relations involving photos of office nameplates were also examined, but did not emerge pre- or posttraining. Two participants produced names orally when given photos and sorted written names and faces together after training; the 3rd participant was unavailable for these posttests. After training, 1 participant located and named all three therapists in their offices.
1. L-NG-nitro arginine methyl ester (L-NAME) administered i.p. produces anti-nociception in the mouse assessed by the formalin-induced paw licking and acetic acid-induced abdominal constriction models. The non-steroidal anti-inflammatory drug (NSAID), flurbiprofen, was similarly anti-nociceptive in both models. 2. Combination of a sub-threshold dose of L-NAME (10 mg kg-1) with increasing doses of flurbiprofen (25- 75 mg kg-1) or a sub-threshold dose of flurbiprofen (50 mg kg-1) with increasing doses of L-NAME (10- 100 mg kg-1) resulted in potentiated anti-nociception in the formalin model. Combined therapy with sub-threshold doses of L-NAME (10 mg kg-1) and indomethacin (10 mg kg-1) also resulted in significant anti-nociception. In addition, combining sub-threshold doses of L-NAME (12.5 mg kg-1) and flurbiprofen (2 mg kg-1) significantly reduced acetic acid-induced abdominal constriction. 3. L-NAME (10 mg kg-1) administered i.p. caused a significant (approximately 35%) increase in MAP in the urethane-anaesthetized mouse. Flurbiprofen (50 mg kg-1) was inactive. Combination treatment with L-NAME (10 mg kg-1) and flurbiprofen (50 mg kg-1) failed to elevate MAP above that observed with L-NAME alone. Neither L-NAME (10 mg kg-1) nor flurbiprofen (50 mg kg-1) either alone or in combination significantly altered mouse locomotor activity. 4. These results suggest that L-NAME and flurbiprofen/indomethacin act synergistically in their anti-nociceptive action in the mouse. Combination therapy with L-NAME and flurbiprofen and a similar NSAID may provide an alternative to the clinical control of pain in man.
The ease of picture naming in children was assessed as a function of two stimulus characteristics: (a) the number of available correct names for a picture (referential uncertainty) and (b) the degree to which a picture realistically represents the depicted object (stimulus realism). Two experiments employing different methods demonstrated that: (a) children named low uncertainty objects (those with a single dominant name, e.g., key, elephant) faster than high uncertainty objects (those with multiple possible correct names, e.g., lamp/light, stove/oven) and (b) this uncertainty effect arose at a stage of naming subsequent to object identification. Possible underlying mechanisms for the uncertainty effect include passive diffusion of activation over multiple object-name pathways or active inhibition among competing candidate names. Stimulus realism (colored photographs vs uncolored line drawings) did not consistently influence naming performance. Implications for understanding children's naming behavior are discussed.
A comparison of naming performance, on the Boston Naming Test, of 52 patients with dementia of Alzheimer's type (DAT), 16 patients with Huntington's disease (HD) and 52 normal control subjects was performed using a comprehensive classification of error types. Spontaneous and cued naming scores were significantly impaired both in the DAT and HD groups, but performance in the DAT patients was significantly worse than that of the HD patients. Normal controls made predominantly semantic-category and circumlocutory errors. The HD group differed from normal only in the proportion of visually based errors, which was greater in the patient group. By contrast, the DAT patients made a significantly greater proportion of semantic-superordinate and semantic-associative errors. The same pattern of naming errors was found when a group of DAT and HD patients matched for overall naming ability was compared. A subgroup of 22 DAT patients was followed longitudinally over 3 y. Their deterioration in overall naming performance was accompanied by a consistent change in the profile of naming errors: the proportion of semantic-associative errors increased significantly as did the proportion of visual errors. These results are considered in the light of current cognitive models of naming. They suggest that in HD, naming deficits initially involve disruption of perceptual analysis, whereas in DAT such impairments in the early stages reflect a breakdown in semantic processes. However, as DAT progresses, perceptual problems also begin to contribute to the patients' naming difficulties. Postlexical (phonemic) processes remain relatively intact throughout in both diseases.
The times taken to name 56 drawings of objects on five separate occasions were analysed for 21 ESN(M) and 21 ESN(S) children, matched for picture-naming vocabulary. The ESN(S) group not only had a higher mean response latency but also showed greater inter- and intra-subject variance. Nine objects were selected whose names have a Thorndike-Lorge language frequency of 50 words per million or greater, and nine others were selected with a frequency of less than 50 words per million. Each object was drawn in two ways, one giving a two-dimensional outline with the addition of important detail, the other drawing also incorporating cues indicating the depth of the object. An analysis of variance of the children's latencies in naming the selected 36 pictures of 18 objects over five trials indicated that the method of drawing had no effect upon naming latencies. Pictures with high-frequency names were named faster than those with lower frequency names, the ESN(S) group showing a greater rate of increase in naming latency for the lower frequency words than the ESN(M) children. Results were discussed in terms of the Oldfield and Lachman models of lexical memory storage and of the search processes required for the retrieval of names.
Functional models of face recognition and speech production have developed separately. However, naming a familiar face is, of course, an act of speech production. In this paper we propose a revision of Bruce and Young's (1986) model of face processing, which incorporates two features of Levelt's (1989) model of speech production. In particular, the proposed model includes two stages of lexical access for names and monitoring of face naming based on a "perceptual loop". Two predictions were derived from the perceptual loop hypothesis of speech monitoring: (1) naming errors in which a (correct) rare surname is erroneously replaced by a common surname should occur more frequently than the reverse substitution (the error asymmetry effect); (2) naming errors in which a common surname is articulated are more likely to be repaired than errors which result in articulation of a rare surname (the error-repairing effect). Both predictions were supported by an analysis of face naming errors in a laboratory face naming task. In a further experiment we considered the possibility that the effects of surname frequency observed in face naming errors could be explained by the frequency sensitivity of lexical access in speech production. However, no effect of the frequency of the surname of the faces used in the previous experiment was found on face naming latencies. Therefore, it is concluded that the perceptual loop hypothesis provides the more parsimonious account of the entire pattern of the results.
Visual event-related potentials (ERPs) were recorded from 15 schizophrenics and 15 age-matched and gender-matched controls, while they performed a modified version of the oddball paradigm. Each subject was required to detect target stimuli among a random sequence of stimuli under two conditions, name and color. In the name condition the stimulus sequence consisted of the subject's family name (deviant 18%), four other family names (standard 73%), and a city name (target 9%). In the color condition the respective stimuli were a pair of solid red circles, four white paired-arrows, and a pair of white plus and minus signs. ERPs elicited by stimuli contained triphasic potentials of P2, N2, and P3. In controls these waves were selectively enhanced for the subject's family name as compared with standards, whereas in schizophrenics no significant difference between the subject's family name and other names was observed. In contrast, selective enhancement for color deviants was observed in both subject groups. These results suggest that impairment of involuntary attention, especially for familiar and significant stimuli such as names in daily life, may underlie disturbances of attentionally controlled central processing in schizophrenia.
In order to identify the process or processes responsible for impaired naming by aphasic patients, ten aphasic adults and ten normal adults performed three independent tasks--picture naming, modified Sternberg picture recognition, and modified Sternberg random shape recognition (Sternberg, 1966). Response times and error percentages were the dependent variables. Independent variables in naming were stimulus codability measured in bits of uncertainty (two levels) and number of naming trials (three trials). Independent variables in the recognition tasks were uncertainty (two levels), number of stimuli to be remembered (two or four stimuli) and response type ("yes" or "no"). The results showed that uncertainty had significant effects on naming but not on recognition performance. The aphasic group produced significantly longer naming response times regardless of uncertainty level. The differences between groups were much greater for high-uncertainty pictures (1100 msec) than for low-uncertainty pictures (270 msec). A comparison of estimates of word retrieval times showed that the two subject groups differed significantly for high-uncertainty but not for low-uncertainty items. It was concluded that (1) use of the term "word retrieval problem" rather than "loss of memory problem" was justified to describe the major component in the aphasic naming impairment for high-uncertainty items, and (2) when naming low-uncertainty items these aphasic subjects did not demonstrate a word retrieval problem. The results indicate that treatment procedures designed to improve naming should be process rather than content oriented.
Speed of word identification is important in the theories of reading proposed by La Berge and Samuels (1974) and Perfetti (1985), and is substantially correlated with reading skill. However, there is controversy about whether disabled readers have a speed deficit that is restricted to the identification of printed words, or if instead, they have a more general speed deficit in retrieving names of even single digits. To investigate this issue, poor and average readers (N = 43) in grade 2 were assessed on several indices of speed of digit and letter naming, using both continuous-list and discrete-trial methodologies. MANCOVA indicated clear effects of reader group on discrete-trial latencies, as well as an interaction between reader group and the speed with which to-be-named items were presented. A series of hierarchical regression analyses explored the amount of shared variance between various measures of digit naming speed and five indices of reading skill. Latency for word identification shares considerable variance with latency for digit naming, and, in general, accounts for the shared variance of naming speed and several other measures of reading skill. Naming speed contributed variance in reading skill. Naming speed contributed variance in reading skill independently of measures of phonological awareness.
Following a left thalamic infarct, a patient showed a marked impairment in retrieving person proper names in response to faces and to verbal description, despite being able to provide precise information about the persons he could not name and to point to their photograph when the name was provided by the examiner. The patient was also impaired in generating proper names, but could easily retrieve common names as well as geographical names and names of monuments. It is hypothesized that the arbitrary nature of the link between proper names and their referents makes access of phonological forms from the semantic store particularly labile. In agreement with this interpretation is the patient's inability to recall telephone numbers and to learn semantically arbitrary paired associates.