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Articles 4141 - 4170 of 4204
Full-Text Articles in Entire DC Network
Development And Validation Of A Professional Behavior Assessment., Kristie Koenig, Caryn Johnson, Cathleen K Morano, Joseph P Ducette
Development And Validation Of A Professional Behavior Assessment., Kristie Koenig, Caryn Johnson, Cathleen K Morano, Joseph P Ducette
Department of Occupational Therapy Faculty Papers
Allied health students must quickly socialize into a professional role as they transition from classroom to clinic. In addition to skill development, students must exhibit a host of professional behaviors that facilitate successful interaction with patients, families, and colleagues. There is a need for a valid, reliable assessment of professional behaviors that contribute to clinical competence. This study reports on the development and validation of a professional behavior assessment for occupational therapy students on a part-time clinical rotation (Level I). The Philadelphia Region Fieldwork Consortium (PRFC) Level I Student Evaluation was developed from an initial survey (n = 75) to …
Family Connectedness And Sexual Risk-Taking Among Urban Youth Attending Alternative High Schools, Christine M Markham, Susan R Tortolero, S Liliana Escobar-Chaves, Guy S Parcel, Ronald Harrist, Robert C Addy
Family Connectedness And Sexual Risk-Taking Among Urban Youth Attending Alternative High Schools, Christine M Markham, Susan R Tortolero, S Liliana Escobar-Chaves, Guy S Parcel, Ronald Harrist, Robert C Addy
Faculty, Staff and Student Publications
CONTEXT: Youth in alternative high schools engage in risky sexual behavior at higher rates than do their peers in regular schools, placing themselves at an increased risk of sexually transmitted disease and unintended pregnancy. Family connectedness is associated with reduced adolescent sexual risk-taking, although this association has not been tested among alternative school youth.
METHODS: A sample of 976 urban, predominantly minority alternative high school students in Houston, Texas, were surveyed in 2000-2002. Survey data were analyzed using logistic regression to determine whether family connectedness is related to sexual risk-taking.
RESULTS: Overall, 68% of students reported ever having had sex. …
Encouraging Adolescents Toward Mental Health Careers Via Website Biographies, Irmi U. Willcockson, Prabhu R. Shankar, Cynthia L. Phelps, Craig W. Johnson
Encouraging Adolescents Toward Mental Health Careers Via Website Biographies, Irmi U. Willcockson, Prabhu R. Shankar, Cynthia L. Phelps, Craig W. Johnson
Faculty, Staff and Student Publications
This project designed, developed, implemented and is currently evaluating the effectiveness of an interactive, multi-media website designed to encourage adolescents to consider careers in mental health. This Web-based learning environment features biographies of mental health scientists. Evaluation is conducted in a systematic, structured way using cognitive achievement, usability (ease of use), and affective scales (e.g., fun to use) as outcome measures
Orthognathic Surgery In The University Of Malaya, Wei Cheong Ngeow
Orthognathic Surgery In The University Of Malaya, Wei Cheong Ngeow
Research Publications (2000 to 2005)
This is the first review on orthognathic surgery in Malaysia. The records of a total of 84 patients seen between 1977 and 1999 in the Department of Oral and Maxillofacial Surgery of the Faculty of Dentistry, University of Malaya were analysed. Skeletal III deformity formed 85 of the sample with a female dominance of 2 to 1. The patients' age ranged from 17 to 36 years, with a mean of 25.3 years. The common surgical techniques used were combined bilateral sagittal split and Le Fort I osteotomy. The predominant ethnic group was Chinese (n=58, 69); followed by Malay (n=14, 17) …
Distinct Neural Systems Subserve Person And Object Knowledge, Jason P. Mitchell, Todd F. Heatherton, C. Neil Macrae
Distinct Neural Systems Subserve Person And Object Knowledge, Jason P. Mitchell, Todd F. Heatherton, C. Neil Macrae
Dartmouth Scholarship
Studies using functional neuroimaging and patient populations have demonstrated that distinct brain regions subserve semantic knowledge for different classes of inanimate objects (e.g., tools, musical instruments, and houses). What this work has yet to consider, however, is how conceptual knowledge about people may be organized in the brain. In particular, is there a distinct functional neuroanatomy associated with person knowledge? By using event-related functional magnetic resonance imaging (fMRI), we measured neural activity while participants made semantic judgments about people or objects. A unique pattern of brain activity was associated with person judgments and included brain regions previously implicated in other …
The Sociophysiology Of Caring In The Doctor-Patient Relationship, Herbert M. Adler
The Sociophysiology Of Caring In The Doctor-Patient Relationship, Herbert M. Adler
Department of Psychiatry and Human Behavior Faculty Papers
The emotional investment required to construct a caring doctor-patient relationship can be justified on humane grounds. Can it also be justified as a direct physiologic intervention? Two lines of evidence point in this direction. People in an empathic relationship exhibit a correlation of indicators of autonomic activity. This occurs between speakers and responsive listeners, members of a coherent group, and bonded pairs of higher social animals. Furthermore, the experience of feeling cared about in a relationship reduces the secretion of stress hormones and shifts the neuroendocrine system toward homeostasis. Because the social engagement of emotions is simultaneously the social engagement …
A 12-Year Prospective Study Of The Long-Term Effects Of Early Child Physical Maltreatment On Psychological, Behavioral, And Academic Problems In Adolescence, Jennifer E Lansford, Kenneth A Dodge, Gregory S Pettit, John E Bates, Joseph Crozier, Julie Kaplow
A 12-Year Prospective Study Of The Long-Term Effects Of Early Child Physical Maltreatment On Psychological, Behavioral, And Academic Problems In Adolescence, Jennifer E Lansford, Kenneth A Dodge, Gregory S Pettit, John E Bates, Joseph Crozier, Julie Kaplow
Faculty, Staff and Students Publications
OBJECTIVE: To determine whether child physical maltreatment early in life has long-term effects on psychological, behavioral, and academic problems independent of other characteristics associated with maltreatment.
DESIGN: Prospective longitudinal study with data collected annually from 1987 through 1999.
SETTING AND PARTICIPANTS: Randomly selected, community-based samples of 585 children from the ongoing Child Development Project were recruited the summer before children entered kindergarten in 3 geographic sites. Seventy-nine percent continued to participate in grade 11. The initial in-home interviews revealed that 69 children (11.8%) had experienced physical maltreatment prior to kindergarten matriculation.
MAIN OUTCOME MEASURES: Adolescent assessment of school grades, standardized …
Child, Parent, And Peer Predictors Of Early-Onset Substance Use: A Multisite Longitudinal Study, Julie B Kaplow, Patrick J Curran, Kenneth A Dodge
Child, Parent, And Peer Predictors Of Early-Onset Substance Use: A Multisite Longitudinal Study, Julie B Kaplow, Patrick J Curran, Kenneth A Dodge
Faculty, Staff and Students Publications
The purpose of this study was to identify kindergarten-age predictors of early-onset substance use from demographic, environmental, parenting, child psychological, behavioral, and social functioning domains. Data from a longitudinal study of 295 children were gathered using multiple-assessment methods and multiple informants in kindergarten and 1st grade. Annual assessments at ages 10, 11, and 12 reflected that 21% of children reported having initiated substance use by age 12. Results from longitudinal logistic regression models indicated that risk factors at kindergarten include being male, having a parent who abused substances, lower levels of parental verbal reasoning, higher levels of overactivity, more thought …
Improved Continuation Rate Of Depot-Medroxyprogesterone Acetate In Adolescent Mothers, Hatim A. Omar, Amy Fowler, Sandy D'Angelo
Improved Continuation Rate Of Depot-Medroxyprogesterone Acetate In Adolescent Mothers, Hatim A. Omar, Amy Fowler, Sandy D'Angelo
Pediatrics Faculty Publications
Poor compliance and high discontinuation rates of Depot-Medroxyprogesterone Acetate (DMPA) and other contraceptive methods are major factors in the continuing problem of adolescent pregnancy. In this study we attempted to determine if providing comprehensive health care for teen mothers and their babies would improve continuation rates of DMPA. Patients who started DMPA between 1/1/96 and 1/1/99 were included. Teen mothers and their babies received all their health care in this clinic, supported by State funding. Key elements regarding DMPA in this clinic were continuity of care, phone and mail reminders of appointments, free DMPA for patients without insurance, counseling at …
Neural Systems For Visual Orienting And Their Relationships To Spatial Working Memory, Maurizio Corbetta, J. Michelle Kincade, Gordon Shulman
Neural Systems For Visual Orienting And Their Relationships To Spatial Working Memory, Maurizio Corbetta, J. Michelle Kincade, Gordon Shulman
Open Access Publications
We investigated neural correlates of human visual orienting using event-related functional magnetic resonance imaging (fMRI). When subjects voluntarily directed attention to a peripheral location, we recorded robust and sustained signals uniquely from the intraparietal sulcus (IPs) and superior frontal cortex (near the frontal eye field, FEF). In the ventral IPs and FEF only, the blood oxygen level dependent signal was modulated by the direction of attention. The IPs and FEF also maintained the most sustained level of activation during a 7-sec delay, when subjects maintained attention at the peripheral cued location (working memory). Therefore, the IPs and FEF form a …
Breast Cancer On The World Wide Web: Cross Sectional Survey Of Quality Of Information And Popularity Of Websites, Funda Meric, Elmer V Bernstam, Nadeem Q Mirza, Kelly K Hunt, Frederick C Ames, Merrick I Ross, Henry M Kuerer, Raphael E Pollock, Mark A Musen, S Eva Singletary
Breast Cancer On The World Wide Web: Cross Sectional Survey Of Quality Of Information And Popularity Of Websites, Funda Meric, Elmer V Bernstam, Nadeem Q Mirza, Kelly K Hunt, Frederick C Ames, Merrick I Ross, Henry M Kuerer, Raphael E Pollock, Mark A Musen, S Eva Singletary
Faculty, Staff and Student Publications
OBJECTIVES: To determine the characteristics of popular breast cancer related websites and whether more popular sites are of higher quality.
DESIGN: The search engine Google was used to generate a list of websites about breast cancer. Google ranks search results by measures of link popularity---the number of links to a site from other sites. The top 200 sites returned in response to the query "breast cancer" were divided into "more popular" and "less popular" subgroups by three different measures of link popularity: Google rank and number of links reported independently by Google and by AltaVista (another search engine).
MAIN OUTCOME …
Spectral And Temporal Processing In Human Auditory Cortex, Deborah A Hall, Ingrid Johnsrude, Mark P Haggard, Alan R Palmer, Michael A Akeroyd, A Quentin Summerfield
Spectral And Temporal Processing In Human Auditory Cortex, Deborah A Hall, Ingrid Johnsrude, Mark P Haggard, Alan R Palmer, Michael A Akeroyd, A Quentin Summerfield
Brain and Mind Institute Researchers' Publications
Hierarchical processing suggests that spectrally and temporally complex stimuli will evoke more activation than do simple stimuli, particularly in non-primary auditory fields. This hypothesis was tested using two tones, a single frequency tone and a harmonic tone, that were either static or frequency modulated to create four stimuli. We interpret the location of differences in activation by drawing comparisons between fMRI and human cytoarchitectonic data, reported in the same brain space. Harmonic tones produced more activation than single tones in right Heschl's gyrus (HG) and bilaterally in the lateral supratemporal plane (STP). Activation was also greater to frequency-modulated tones than …
Retrospective Analysis Of Youth Evaluated For Suicide Attempt Or Suicidal Ideation In An Emergency Room Setting, Julie Hagedorn, Hatim A. Omar
Retrospective Analysis Of Youth Evaluated For Suicide Attempt Or Suicidal Ideation In An Emergency Room Setting, Julie Hagedorn, Hatim A. Omar
Pediatrics Faculty Publications
Suicide is the third leading cause of death in adolescents and a major contributor to morbidity in this age group. The objective of this study was to look at the demographics, major stressors and factors leading to attempting suicide as well as the methods of attempted suicide in adolescents admitted to two hospitals in a medium size city. Medical records were reviewed of adolescents admitted to two area hospitals for attempted suicide between 7/1/97-12/31/99. Coroner's data on completed suicide were also reviewed. In the study period a total of 287 persons aged 21 years or under were admitted for attempted …
Toward A Cognitive Taxonomy Of Medical Errors, Jiajie Zhang, Vimla L Patel, Todd R Johnson, Edward H Shortliffe
Toward A Cognitive Taxonomy Of Medical Errors, Jiajie Zhang, Vimla L Patel, Todd R Johnson, Edward H Shortliffe
Faculty, Staff and Student Publications
One critical step in addressing and resolving the problems associated with human errors is the development of a cognitive taxonomy of such errors. In the case of errors, such a taxonomy may be developed (1) to categorize all types of errors along cognitive dimensions, (2) to associate each type of error with a specific underlying cognitive mechanism, (3) to explain why, and even predict when and where, a specific error will occur, and (4) to generate intervention strategies for each type of error. Based on Reason's (1992) definition of human errors and Norman's (1986) cognitive theory of human action, we …
Can Meaningful Effective Connectivities Be Obtained Between Auditory Cortical Regions?, M S Gonçalves, D A Hall, Ingrid Johnsrude, M P Haggard
Can Meaningful Effective Connectivities Be Obtained Between Auditory Cortical Regions?, M S Gonçalves, D A Hall, Ingrid Johnsrude, M P Haggard
Brain and Mind Institute Researchers' Publications
Structural equation modeling (SEM) of neuroimaging data can be evaluated both for the goodness of fit of the model and for the strength of path coefficients (as an index of effective connectivity). SEM of auditory fMRI data is made difficult by the necessary sparse temporal sampling of the time series (to avoid contamination of auditory activation by the response to scanner noise) and by the paucity of well-defined anatomical information to constrain the functional model. We used SEM (i.e., a model incorporating latent variables) to investigate how well fMRI data in four adjacent cortical fields can be described as an …
A Longitudinal Investigation Of Information Processing And Cognitive Organization In Clinical Depression: Stability Of Schematic Interconnectedness., D J Dozois, K S Dobson
A Longitudinal Investigation Of Information Processing And Cognitive Organization In Clinical Depression: Stability Of Schematic Interconnectedness., D J Dozois, K S Dobson
Psychology Publications
This study longitudinally investigated information processing and cognitive organization in clinical depression. The main hypothesis was that individuals whose depression had remitted would show a significant cognitive shift on information processing (e.g., deactivation of negative processing) but not on cognitive organizational tasks, Forty-five individuals with clinical depression completed 2 information processing and 2 cognitive organizational tasks at initial assessment. At 6-month follow-up, the sample (23 remitted, 22 stable depressed) was readministered the tasks. As expected, information processing shifted significantly in individuals who had improved symptomatically, whereas negative cognitive organizational indices remained stable. The implications of these results are discussed as …
Internet Facilitation Of Opioid Dependence., D Z Lieberman
Internet Facilitation Of Opioid Dependence., D Z Lieberman
Psychiatry and Behavioral Sciences Faculty Publications
No abstract provided.
Spirituality In Late Adulthood, Lisa M. Heintz, Imants Barušs
Spirituality In Late Adulthood, Lisa M. Heintz, Imants Barušs
Psychology
MacDonald's Expressions of Spirituality Inventory was used to examine spirituality in late adulthood using a sample of 30 people (22 women, 8 men) whose mean age was 72.6 yr. While average scores are higher on scales measuring spiritual and religious beliefs and practices for the sample than for a standardization group of undergraduate students with a mean age of 21.0 yr., means are lower on scales measuring paranormal beliefs. Low scores on death anxiety are correlated only with Existential Well-being and age. And, while some religious behaviors such as frequent religious practice, prayer, and church attendance are correlated with some …
An Open-Label Trial Of Tomoxetine In Pediatric Attention Deficit Hyperactivity Disorder., Christopher J. Kratochvil, Daryl Bohac, Martin Harrington, Natalie Baker, Diane E. May, William J. Burke
An Open-Label Trial Of Tomoxetine In Pediatric Attention Deficit Hyperactivity Disorder., Christopher J. Kratochvil, Daryl Bohac, Martin Harrington, Natalie Baker, Diane E. May, William J. Burke
Journal Articles: Psychiatry
OBJECTIVE: To collect pilot data assessing the safety, tolerability, and efficacy of tomoxetine, a nonstimulant norepinephrine enhancer, in pediatric attention deficit hyperactivity disorder (ADHD).
METHODS: An open-label trial of tomoxetine in pediatric ADHD was conducted as part of a multisite clinical trial. Following a baseline assessment, an ascending dose titration was completed during 10 weekly visits.
RESULTS: Ten subjects were enrolled at baseline, with eight completing the study. Seven of the eight remaining subjects met efficacy criteria. Significant decreases in symptom severity ratings by parents and study investigators were found. The medication was well tolerated, with transient appetite suppression the …
Eye Position Sense Contributes To The Judgement Of Slant., F M James, S Whitehead, G K Humphrey, M S Banks, T Vilis
Eye Position Sense Contributes To The Judgement Of Slant., F M James, S Whitehead, G K Humphrey, M S Banks, T Vilis
Brain and Mind Institute Researchers' Publications
We measured monocular judgements of the slant of a cube face while varying eye position in the absence of stereoscopic and external lighting cues. Errors were found to be small, only 10% on average of the cube's eccentricity. Two factors appear to have contributed approximately equally to this error: an underestimate of cube slant as seen by the eye and an underestimate of eye position. When prism adaptation altered the sensed eye position, the pattern of slant judgements changed to reflect the altered sense of eye position.
Role Perceptions Of Occupational Therapists Providing Support And Education For Caregivers Of Persons With Dementia., Susan Toth-Cohen
Role Perceptions Of Occupational Therapists Providing Support And Education For Caregivers Of Persons With Dementia., Susan Toth-Cohen
Department of Occupational Therapy Faculty Papers
OBJECTIVE: This pilot study explored occupational therapists' perceptions of their roles as interventionists providing education and support for caregivers of persons with dementia. The intervention was provided in caregivers' homes as part of a larger funded study.
METHOD: Interviews were conducted with four occupational therapists to elicit their reflections on practice and their views on occupational therapy services on the basis of their experiences providing support and education for caregivers in the funded study.
RESULTS: Key themes consisted of the contrasts between the therapists' roles in the study and their customary practices and the professional and personal impact of their …
Eye Position Signal Modulates A Human Parietal Pointing Region During Memory-Guided Movements., J F Desouza, S P Dukelow, J S Gati, R S Menon, R A Andersen, T Vilis
Eye Position Signal Modulates A Human Parietal Pointing Region During Memory-Guided Movements., J F Desouza, S P Dukelow, J S Gati, R S Menon, R A Andersen, T Vilis
Brain and Mind Institute Researchers' Publications
Using functional magnetic resonance imaging, we examined the signal in parietal regions that were selectively activated during delayed pointing to flashed visual targets and determined whether this signal was dependent on the fixation position of the eyes. Delayed pointing activated a bilateral parietal area in the intraparietal sulcus (rIPS), rostral/anterior to areas activated by saccades. During right-hand pointing to centrally located targets, the left rIPS region showed a significant increase in activation when the eye position was rightward compared with leftward. As expected, activation in motor cortex showed no modulation when only eye position changed. During pointing to retinotopically identical …
Children Of Alcoholics: An Update., D Z Lieberman
Children Of Alcoholics: An Update., D Z Lieberman
Psychiatry and Behavioral Sciences Faculty Publications
One of four children in the United States lives in a family in which the child is exposed to alcoholism. Children of alcoholics (COAs) are two to ten times more likely to develop alcoholism than non-COAs. This paper reviews studies that have attempted to identify risk factors that mediate the increased vulnerability and the protective factors that moderate the risk. Factors discussed include parental antisocial personality disorder, externalizing behavior, internalizing symptoms, differential response to the effects of alcohol, and positive and negative alcohol-related expectancies. The heterogeneous nature of COAs is emphasized, and some of the challenges related to treatment and …
Navigation-Related Structural Change In The Hippocampi Of Taxi Drivers, E A Maguire, D G Gadian, Ingrid Johnsrude, C D Good, J Ashburner, R S Frackowiak, C D Frith
Navigation-Related Structural Change In The Hippocampi Of Taxi Drivers, E A Maguire, D G Gadian, Ingrid Johnsrude, C D Good, J Ashburner, R S Frackowiak, C D Frith
Brain and Mind Institute Researchers' Publications
Structural MRIs of the brains of humans with extensive navigation experience, licensed London taxi drivers, were analyzed and compared with those of control subjects who did not drive taxis. The posterior hippocampi of taxi drivers were significantly larger relative to those of control subjects. A more anterior hippocampal region was larger in control subjects than in taxi drivers. Hippocampal volume correlated with the amount of time spent as a taxi driver (positively in the posterior and negatively in the anterior hippocampus). These data are in accordance with the idea that the posterior hippocampus stores a spatial representation of the environment …
Intimate Partner Violence Among Men And Women In South Carolina, 1998, Ann L. Coker, Christina Derrick, Julia L. Lumpkin, Robert Oldendick, R H. Potter
Intimate Partner Violence Among Men And Women In South Carolina, 1998, Ann L. Coker, Christina Derrick, Julia L. Lumpkin, Robert Oldendick, R H. Potter
CRVAW Faculty Journal Articles
Few studies provide population-based estimates of intimate partner violence (IPV) for men and women, especially at the state level. IPV may result in adverse health effects for victims and perpetrators (1-3). To estimate the lifetime incidence of IPV by type of violence (e.g., physical, sexual, and perceived emotional abuse) and to explore demographic correlates of reporting IPV among men and women, the South Carolina Department of Health and Environmental Control and the University of South Carolina conducted a population-based random-digit-dialed telephone survey of adults in the state. This report summarizes the results of the survey, which indicated that approximately 25% …
Basics Of Research (Part 13): Qualitative Research--An Example, Cheryl Thompson, Edward A. Panacek
Basics Of Research (Part 13): Qualitative Research--An Example, Cheryl Thompson, Edward A. Panacek
Journal Articles: College of Nursing
No abstract provided.
Clinical Interpretation Of "Health And The Human Spirit For Occupation"., Janice P. Burke
Clinical Interpretation Of "Health And The Human Spirit For Occupation"., Janice P. Burke
Department of Occupational Therapy Faculty Papers
In reading and contemplating Yenca's (1998) article, I was immediately struck by the utility of the ideas she offers on a number of clinical fronts. We are presented with occupation-based strategies that are directly applicable to our work with patients and program development; we can make use of the language and ideas that are offered as a way to begin talking to one another (therapist to therapist) in clinical settings about occupation; and we are given the opportunity to think about the contribution, value, and efficacy of occupation and how we might convert those ideas into clinically based research actions. …
Basics Of Research (Part 12): Qualitative Research, Cheryl Thompson, B. Lee Walker
Basics Of Research (Part 12): Qualitative Research, Cheryl Thompson, B. Lee Walker
Journal Articles: College of Nursing
Although both the assumptions and methods of qualitative and quantitative approaches in nursing research are different, both have the goal of furthering the scientific basis for practice. A variety of qualitative approaches are available, and which approach to use depends on the purpose of the research. In general, qualitative investigations address broad questions related to description, discovery, or theory building, and, as a consequence, the researcher is concerned with the entire context surrounding the phenomenon of interest rather than concentrating on specific variables thought to influence that phenomenon. The type of data collected and the methods of analysis differ, but …
How Occupational Therapists Teach Older Patients To Use Bathing And Dressing Devices In Rehabilitation., Ruth Levine Schemm, Laura N. Gitlin
How Occupational Therapists Teach Older Patients To Use Bathing And Dressing Devices In Rehabilitation., Ruth Levine Schemm, Laura N. Gitlin
Department of Occupational Therapy Faculty Papers
OBJECTIVE: This article describes the methods occupational therapists use to teach bathing and dressing device use to older patients in rehabilitation programs. The relationship of three patient characteristics to five aspects of assistive device instruction was examined.
METHOD: The study sample included 86 patients and 19 occupational therapists who provided the assistive device training. Patients were 55 years of age or older and in rehabilitation for an orthopedic deficit, cerebrovascular accident, or lower limb amputation. Therapists recorded information on teaching methods, perceptions of patient knowledge, and expectations for future device use after each treatment session.
RESULTS: Patients received an average …
Student Level Ii Fieldwork Failure: Strategies For Intervention., Sharon A. Gutman, Paula Mccreedy, Prudence Heisler
Student Level Ii Fieldwork Failure: Strategies For Intervention., Sharon A. Gutman, Paula Mccreedy, Prudence Heisler
Department of Occupational Therapy Faculty Papers
OBJECTIVE: This report describes how common student communicative and behavioral characteristics that appear to predict the existence of potential problems during Level II fieldwork were identified in order to develop and implement preventative interventions during the academic curriculum at New York University (NYU). RECORD REVIEW: A record review of NYU professional-level occupational therapy students from 1986 to 1995 was completed to identify common factors among students who performed well academically but failed clinical fieldwork. Eight communicative and behavioral characteristics were identified: (a) rigidity of thinking, (b) discomfort with the ambiguity that accompanies clinical reasoning, (c) lack of psychological insight, (d) …