Universal precautions: employee resistance and strategies for planned organizational change.

Health care organizations have been strongly encouraged to design and implement procedures to prevent the spread of HIV/AIDS in the workplace. The procedures will have a dramatic impact on the work habits of health care workers and may even challenge some dominant health care values. Therefore, precautionary procedures are likely to meet with mixed reactions and, perhaps, outright resistance from health care workers. This article identifies some plausible causes for employee resistance to precautionary procedures. After describing the dilemma in terms of competing values and conflicting objectives, some practical managerial strategies for reconciling differences and securing broad-based commitment to preventive policies and procedures are proposed.

Interobserver reliability and perceptual ratings: more than meets the ear.

The purpose of this study was to examine the reliability of ratings of perceptual characteristics for 10 ataxic dysarthric subjects. The influence of the occurrence of "deviant" speech parameters on the calculation of reliability coefficients was also explored. Results indicated that overall interobserver agreement levels for minimally trained judges compared favorably to reliability coefficients reported in previous studies. Furthermore, levels of overall agreement were above levels of agreement expected on the basis of chance alone. In contrast to overall interobserver agreement, much lower levels of interobserver agreement were obtained when "occurrence reliability" coefficients were calculated for deviant dimensions alone. However, occurrence reliability coefficients surpassed the level of agreement expected on the basis of chance alone for all subjects. Based on the results of this investigation, recommendations are made for modifying standard practices for obtaining interobserver reliability for perceptual ratings of speech characteristics.

Flexibility of single-subject experimental designs. Part II: Design selection and arrangement of experimental phases.

The purpose of this paper is to present a taxonomy of single-subject experimental designs and discuss relevant examples that underscore the versatility and flexibility of this approach to clinical research. The proposed taxonomy serves as a heuristic model that may facilitate an understanding of single-subject experimental designs. Four general evaluation strategies employed in applied research--treatment-no treatment comparison, component assessment, treatment-treatment comparison, and successive level analysis--are discussed within this schema. Each of these evaluation strategies is related to commonly posed clinical research questions, and published examples of design options that address these questions are presented. Throughout the discussion basic considerations relating to appropriate design selection are reviewed.

An experimental analysis of auxiliary and copula verb generalization in aphasia.

Two subjects with chronic Broca's aphasia were taught to produce third person singular auxiliary is in sentence contexts to determine if is production would generalize to untrained auxiliary is items and to copula is contexts. A single subject (ABAB) reversal design was employed. Results revealed that training a few exemplars of the present tense auxiliary is resulted in generalized responding to untrained auxiliary is and copula is plus predicate adjective items. Generalized responding to untrained copula is plus predicate nominative and locative items was marked by individual variability. Although auxiliary and copula is verb production was maintained on 2- and 6-week follow-up probes, transfer to spontaneous speech was negligible. The results were interpreted as providing partial support for the existence of a functional or generative response class between verbal auxiliary and the copula is verbs.