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• 21. [Article] Developing One's Self: Adoption and Identity Formation Through the Eyes of Transracially Adopted Native American Adults

  Life story methods were used to explore the contextual factors that influenced the experiences and identity formation of seven Native American adults who were transracially adopted prior to the passage ...

  Citation × Citation Citation Abstract Copy Title: Developing One's Self: Adoption and Identity Formation Through the Eyes of Transracially Adopted Native American Adults Author: Becker-Green, Jody Year: 2009 Life story methods were used to explore the contextual factors that influenced the experiences and identity formation of seven Native American adults who were transracially adopted prior to the passage of the Indian Child Welfare Act of 1978. These methods provided a deeper understanding of how these individuals have integrated their adoption experiences into their evolving sense of self. The life story methodology offered a way to acknowledge and validate participants' life experiences and allowed for the collection of rich information from the perspectives of the adoptees. The life story interviews were structured to gather information on the influence of one's adoptive family and cultural, social, and educational experiences on participants' developing sense of self. Even though an interview guide was developed for use in the study, each story uniquely unfolded in a manner the participant was comfortable sharing. The study examined the life stories for patterns or emerging themes related to identity development at different points in the narrators' life cycles in order to develop an aggregate account of the contextual factors influencing identity formation as well as a collective understanding of sense of self. The study identified 12 contextual factors that have both positively and negatively influenced identity development among the participants throughout their lifespan. These factors are: (1) adoptive family; (2) community; (3) educational experiences; (4) religion/spirituality; (5) travel; (6) exposure to cultural experiences; (7) employment; (8) friendships; (9) peer groups; (10) military; (11) societal messages, and (12) reconnection to tribal heritage. Overall, findings from this study suggest that the majority of participants have developed strong Native American, multi-cultural, and/or bi-cultural identities that incorporate their various experiences as transracial adoptees. Practice considerations for transracial adoptees as well as adoptive parents are suggested. Policy implications relating to granting access to original birth and/or adoption related records are presented. Finally, future research recommendations are offered specific to Native American transracial adoptees, their biological families, and tribal communities from which they adopted. While the practice, policy, and research recommendations are specific to Native American transracial adoptees, the recommendations may have broader implications to a wider population of adoptees in general. Title: Developing One's Self: Adoption and Identity Formation Through the Eyes of Transracially Adopted Native American Adults Author: Becker-Green, Jody Year: 2009 Life story methods were used to explore the contextual factors that influenced the experiences and identity formation of seven Native American adults who were transracially adopted prior to the passage of the Indian Child Welfare Act of 1978. These methods provided a deeper understanding of how these individuals have integrated their adoption experiences into their evolving sense of self. The life story methodology offered a way to acknowledge and validate participants' life experiences and allowed for the collection of rich information from the perspectives of the adoptees. The life story interviews were structured to gather information on the influence of one's adoptive family and cultural, social, and educational experiences on participants' developing sense of self. Even though an interview guide was developed for use in the study, each story uniquely unfolded in a manner the participant was comfortable sharing. The study examined the life stories for patterns or emerging themes related to identity development at different points in the narrators' life cycles in order to develop an aggregate account of the contextual factors influencing identity formation as well as a collective understanding of sense of self. The study identified 12 contextual factors that have both positively and negatively influenced identity development among the participants throughout their lifespan. These factors are: (1) adoptive family; (2) community; (3) educational experiences; (4) religion/spirituality; (5) travel; (6) exposure to cultural experiences; (7) employment; (8) friendships; (9) peer groups; (10) military; (11) societal messages, and (12) reconnection to tribal heritage. Overall, findings from this study suggest that the majority of participants have developed strong Native American, multi-cultural, and/or bi-cultural identities that incorporate their various experiences as transracial adoptees. Practice considerations for transracial adoptees as well as adoptive parents are suggested. Policy implications relating to granting access to original birth and/or adoption related records are presented. Finally, future research recommendations are offered specific to Native American transracial adoptees, their biological families, and tribal communities from which they adopted. While the practice, policy, and research recommendations are specific to Native American transracial adoptees, the recommendations may have broader implications to a wider population of adoptees in general. Close

• 22. [Article] Predictors of depression in American Indian adolescents

  Discriminant analysis was conducted to examine the empirical use of psychosocial variables and stressful life events scales in classifying depressed and non-depressed American Indian adolescents using ...

  Citation × Citation Citation Abstract Copy Title: Predictors of depression in American Indian adolescents Author: Duong-Tran, Quang Year: 1989 Discriminant analysis was conducted to examine the empirical use of psychosocial variables and stressful life events scales in classifying depressed and non-depressed American Indian adolescents using a standardized criterion measure. Subjects attending a Bureau of Indian Affair boarding school were administered a mental health screening survey and were interviewed within four weeks using the Diagnostic Interview Schedule f or Children-Revised (DISC-R). Three models of discriminant analysis were used to determine the overall and incremental variance contributed by the stressful life events scales and the related psychosocial variables (i.e., gender, perceived social support from family and from friends, self-esteem, and depressive symptoms) to the criterion variable of depression. Results indicated that none of the models contributed significantly to the overall and unique variance in the classification of the groups. It is recommended that psychosocial correlates other than those that had been identified in this study (e.g. substance abuse, suicide behaviors, etc.) need to be examined and considered in future examination of American Indian adolescent depression. Title: Predictors of depression in American Indian adolescents Author: Duong-Tran, Quang Year: 1989 Discriminant analysis was conducted to examine the empirical use of psychosocial variables and stressful life events scales in classifying depressed and non-depressed American Indian adolescents using a standardized criterion measure. Subjects attending a Bureau of Indian Affair boarding school were administered a mental health screening survey and were interviewed within four weeks using the Diagnostic Interview Schedule f or Children-Revised (DISC-R). Three models of discriminant analysis were used to determine the overall and incremental variance contributed by the stressful life events scales and the related psychosocial variables (i.e., gender, perceived social support from family and from friends, self-esteem, and depressive symptoms) to the criterion variable of depression. Results indicated that none of the models contributed significantly to the overall and unique variance in the classification of the groups. It is recommended that psychosocial correlates other than those that had been identified in this study (e.g. substance abuse, suicide behaviors, etc.) need to be examined and considered in future examination of American Indian adolescent depression. Close

• 23. [Article] Peer Interaction in Rural Preschool Classrooms: Contributions of Children's Learning-Related Behaviors, Language and Literacy Skills, and Problem Behaviors

  Peer interaction contributes strongly to children’s development and learning, but the processes by which peer interaction is shaped in preschool classrooms, particularly classrooms in rural communities, ...

  Citation × Citation Citation Abstract Copy Title: Peer Interaction in Rural Preschool Classrooms: Contributions of Children's Learning-Related Behaviors, Language and Literacy Skills, and Problem Behaviors Author: Lin, Tzu-Jung, Justice, Laura M., Narmada, Paul, Mashburn, Andrew J. Year: 2016 Peer interaction contributes strongly to children’s development and learning, but the processes by which peer interaction is shaped in preschool classrooms, particularly classrooms in rural communities, are largely unknown. This study aimed to examine the patterns of peer interaction in rural preschool classrooms as a way to extrapolate how children influence each other in their day-to-day social interaction. Included in this study were 270 preschoolers (Mean age = 53 months, SD = 3.2) from 61 preschool classrooms located in rural communities that primarily served children from low-income families. Results of actor-partner interdependence models demonstrate significant homophily effects of children’s learning-related behaviors and language and literacy skills, after accounting for gender and problem behavior homophily. The similarity of learning-related behaviors between a dyad mediated the relationship between their problem behaviors and the frequency of peer interaction. Children’s language and literacy skills were similar to the skills of their peers with whom they interacted more often toward the end of the academic year. These findings have implications for understanding and improving peer interaction in rural preschool classrooms. Title: Peer Interaction in Rural Preschool Classrooms: Contributions of Children's Learning-Related Behaviors, Language and Literacy Skills, and Problem Behaviors Author: Lin, Tzu-Jung, Justice, Laura M., Narmada, Paul, Mashburn, Andrew J. Year: 2016 Peer interaction contributes strongly to children’s development and learning, but the processes by which peer interaction is shaped in preschool classrooms, particularly classrooms in rural communities, are largely unknown. This study aimed to examine the patterns of peer interaction in rural preschool classrooms as a way to extrapolate how children influence each other in their day-to-day social interaction. Included in this study were 270 preschoolers (Mean age = 53 months, SD = 3.2) from 61 preschool classrooms located in rural communities that primarily served children from low-income families. Results of actor-partner interdependence models demonstrate significant homophily effects of children’s learning-related behaviors and language and literacy skills, after accounting for gender and problem behavior homophily. The similarity of learning-related behaviors between a dyad mediated the relationship between their problem behaviors and the frequency of peer interaction. Children’s language and literacy skills were similar to the skills of their peers with whom they interacted more often toward the end of the academic year. These findings have implications for understanding and improving peer interaction in rural preschool classrooms. Close

• 24. [Article] Obesity : Two Behavioral Approaches to Weight Reduction

  Much of the research on obesity has been designed to explore its relationship to the behavior of overeating. Although a number of physiological, societal, cultural and family background variables have ...

  Citation × Citation Citation Abstract Copy Title: Obesity : Two Behavioral Approaches to Weight Reduction Author: Davidson, Albert Blake Year: 1975 Much of the research on obesity has been designed to explore its relationship to the behavior of overeating. Although a number of physiological, societal, cultural and family background variables have been detailed, researchers have sought an approach that does not rely heavily on these considerations. Most weight reduction programs fail to recognize and concentrate on empirically demonstrated differences between obese and normal subjects. Researchers have shown that obese subjects seem to be more sensitive to external than internal stimuli. A behavioral approach to weight reduction that emphasizes and uses these external stimuli was hypothesized to be the treatment of choice. A Self-Modification program was designed to maximize the use of external stimuli. An Aversion Therapy approach that utilized electrostimulation was the alternative treatment procedure. The two treatment procedures were compared with a Control approach. Each of the two treatment approaches and the Control approach consisted of twelve subjects. Title: Obesity : Two Behavioral Approaches to Weight Reduction Author: Davidson, Albert Blake Year: 1975 Much of the research on obesity has been designed to explore its relationship to the behavior of overeating. Although a number of physiological, societal, cultural and family background variables have been detailed, researchers have sought an approach that does not rely heavily on these considerations. Most weight reduction programs fail to recognize and concentrate on empirically demonstrated differences between obese and normal subjects. Researchers have shown that obese subjects seem to be more sensitive to external than internal stimuli. A behavioral approach to weight reduction that emphasizes and uses these external stimuli was hypothesized to be the treatment of choice. A Self-Modification program was designed to maximize the use of external stimuli. An Aversion Therapy approach that utilized electrostimulation was the alternative treatment procedure. The two treatment procedures were compared with a Control approach. Each of the two treatment approaches and the Control approach consisted of twelve subjects. Close

• 25. [Article] The effects of test result and diagnosticity on physicians' revisions of probability of disease in medical diagnosis

  This study examined the effects of sensitivity, specificity and result of diagnostic tests on the uses which physicians make of those results. These were compared with the Bayesian model of probability ...

  Citation × Citation Citation Abstract Copy Title: The effects of test result and diagnosticity on physicians' revisions of probability of disease in medical diagnosis Author: Sinclair, Ann Elizabeth Year: 1987 This study examined the effects of sensitivity, specificity and result of diagnostic tests on the uses which physicians make of those results. These were compared with the Bayesian model of probability adjustment, which is generally accepted for medical diagnosis. Ninety six active members of the Oregon Academy of Family Physicians were interviewed by telephone, using a case scenario describing a patient with a newly discovered breast lump. Subjects estimated prior probability of malignancy, based on history and physical findings, and then estimated posterior probability following results of a mammogram. Mammograms varied by result (positive or negative) and by high and low values for sensitivity and specificity. Subjects were asked to indicate their confidence in each probability estimate. About one third of the subjects were also asked for their treatment threshold -- that point at which they would change from a policy of watchful waiting to one of taking some action, which was usually biopsy of the lesion. Title: The effects of test result and diagnosticity on physicians' revisions of probability of disease in medical diagnosis Author: Sinclair, Ann Elizabeth Year: 1987 This study examined the effects of sensitivity, specificity and result of diagnostic tests on the uses which physicians make of those results. These were compared with the Bayesian model of probability adjustment, which is generally accepted for medical diagnosis. Ninety six active members of the Oregon Academy of Family Physicians were interviewed by telephone, using a case scenario describing a patient with a newly discovered breast lump. Subjects estimated prior probability of malignancy, based on history and physical findings, and then estimated posterior probability following results of a mammogram. Mammograms varied by result (positive or negative) and by high and low values for sensitivity and specificity. Subjects were asked to indicate their confidence in each probability estimate. About one third of the subjects were also asked for their treatment threshold -- that point at which they would change from a policy of watchful waiting to one of taking some action, which was usually biopsy of the lesion. Close

• 26. [Article] Patients and Nurses and Doctors Oh My!: Nurse Retention from a Multi-Foci Aggression Perspective

  Attrition is a serious issue in the nursing industry. One factor influencing rates of attrition in nursing is aggression victimization at work (Estryn-Behar et al., 2010). However, there is little research ...

  Citation × Citation Citation Abstract Copy Title: Patients and Nurses and Doctors Oh My!: Nurse Retention from a Multi-Foci Aggression Perspective Author: Novak, Kevin Oliver Year: 2017 Attrition is a serious issue in the nursing industry. One factor influencing rates of attrition in nursing is aggression victimization at work (Estryn-Behar et al., 2010). However, there is little research in the aggression literature that examines how aggression from different sources affects attrition (both job and career turnover) differently. This study attempts to better understand the linkages between aggression victimization and nursing attrition; specifically how aggression from different sources (i.e. patients/patients’ families, coworkers, and licensed independent practitioners) differentially affects retention factors (i.e. job satisfaction, turnover intentions, and career commitment). This study also attempts to understand the role that prosocial motivation may have in buffering against negative work attitudes brought about by patient aggression victimization. A two time point cross-sectional survey design was conducted in a hospital organization in the state of Oregon. The data presented here are part of an archival examination of that larger dataset that uses 337 voluntary nursing participants. Findings partially support the idea that different sources of aggression differentially affect retention outcomes like job satisfaction, turnover intentions, and career commitment. Some limitations and contributions of the study are also discussed. Title: Patients and Nurses and Doctors Oh My!: Nurse Retention from a Multi-Foci Aggression Perspective Author: Novak, Kevin Oliver Year: 2017 Attrition is a serious issue in the nursing industry. One factor influencing rates of attrition in nursing is aggression victimization at work (Estryn-Behar et al., 2010). However, there is little research in the aggression literature that examines how aggression from different sources affects attrition (both job and career turnover) differently. This study attempts to better understand the linkages between aggression victimization and nursing attrition; specifically how aggression from different sources (i.e. patients/patients’ families, coworkers, and licensed independent practitioners) differentially affects retention factors (i.e. job satisfaction, turnover intentions, and career commitment). This study also attempts to understand the role that prosocial motivation may have in buffering against negative work attitudes brought about by patient aggression victimization. A two time point cross-sectional survey design was conducted in a hospital organization in the state of Oregon. The data presented here are part of an archival examination of that larger dataset that uses 337 voluntary nursing participants. Findings partially support the idea that different sources of aggression differentially affect retention outcomes like job satisfaction, turnover intentions, and career commitment. Some limitations and contributions of the study are also discussed. Close

• 27. [Article] Friendship between women : the influence of incest

  This study focused on the mother/daughter relationship in father/daughter incest and how that relationship influences women's friendships with other women. Many researchers have concluded that females ...

  Citation × Citation Citation Abstract Copy Title: Friendship between women : the influence of incest Author: Lockert, Laurie Year: 1987 This study focused on the mother/daughter relationship in father/daughter incest and how that relationship influences women's friendships with other women. Many researchers have concluded that females who were sexually abused by male authority figures, i.e., father, step-father, grandfather, older brother, minister, babysitter, will have impaired relationships with men. Clinicians surmise that the enormous betrayal of trust involved in the incest leads the child to generalize from her experience with one male to all males. Victims express feelings of distrust, fear of intimacy, and fear of personal expression in all male/female relationships. Studies suggest that in families where father/daughter incest has occurred the relationships between mother and daughter are also impaired. Most often cited is the distant relationship between the mother and daughter. Also discussed is the intense anger the daughter feels toward the mother for not protecting her from the perpetrator's abuse. Betrayal, in the form of the mother's inability to provide protection, often evokes more anger from the daughter than does the father's betrayal. Title: Friendship between women : the influence of incest Author: Lockert, Laurie Year: 1987 This study focused on the mother/daughter relationship in father/daughter incest and how that relationship influences women's friendships with other women. Many researchers have concluded that females who were sexually abused by male authority figures, i.e., father, step-father, grandfather, older brother, minister, babysitter, will have impaired relationships with men. Clinicians surmise that the enormous betrayal of trust involved in the incest leads the child to generalize from her experience with one male to all males. Victims express feelings of distrust, fear of intimacy, and fear of personal expression in all male/female relationships. Studies suggest that in families where father/daughter incest has occurred the relationships between mother and daughter are also impaired. Most often cited is the distant relationship between the mother and daughter. Also discussed is the intense anger the daughter feels toward the mother for not protecting her from the perpetrator's abuse. Betrayal, in the form of the mother's inability to provide protection, often evokes more anger from the daughter than does the father's betrayal. Close

• 28. [Image] Othniel R. Chambers, left

  	Othniel Robert Chambers was a professor of psychology at Oregon State College from 1929 until his death in 1951. Born in Jasper, Indiana on April 19, 1894, Chambers received his A.B. and M.A. from Indiana ...
  	Citation × Citation Citation Abstract Copy Title: Othniel R. Chambers, left Year: 1940 Othniel Robert Chambers was a professor of psychology at Oregon State College from 1929 until his death in 1951. Born in Jasper, Indiana on April 19, 1894, Chambers received his A.B. and M.A. from Indiana University (1922) and his Ph.D. from Ohio State University (1926). He taught at Ohio State University in 1923-1926 and at the University of Texas in 1926-1929. In 1929, Chambers moved to Oregon, where he became a professor and head of Oregon State College’s Department of Psychology. During the 1930s and 1940s, he gave numerous radio lectures for KOAC. Chambers was active in numerous psychological associations throughout the region. He served as president of the Benton County Hygiene Committee (1950) and was a member of the Pacific Northwest Council of Family Relations. He was also a member of numerous social and honorary societies. Title: Othniel R. Chambers, left Year: 1940 Othniel Robert Chambers was a professor of psychology at Oregon State College from 1929 until his death in 1951. Born in Jasper, Indiana on April 19, 1894, Chambers received his A.B. and M.A. from Indiana University (1922) and his Ph.D. from Ohio State University (1926). He taught at Ohio State University in 1923-1926 and at the University of Texas in 1926-1929. In 1929, Chambers moved to Oregon, where he became a professor and head of Oregon State College’s Department of Psychology. During the 1930s and 1940s, he gave numerous radio lectures for KOAC. Chambers was active in numerous psychological associations throughout the region. He served as president of the Benton County Hygiene Committee (1950) and was a member of the Pacific Northwest Council of Family Relations. He was also a member of numerous social and honorary societies. Close

• 29. [Article] The relationship of group support, majority status, and interpersonal dependency in predicting intimate partner violence

  One of the most common community responses to intimate partner violence is batterer intervention programs (BIPs), which are aimed at ending perpetrators' violent behavior. Unfortunately, however, the success ...

  Citation × Citation Citation Abstract Copy Title: The relationship of group support, majority status, and interpersonal dependency in predicting intimate partner violence Author: Gray, Mary Elisabeth Year: 2009 One of the most common community responses to intimate partner violence is batterer intervention programs (BIPs), which are aimed at ending perpetrators' violent behavior. Unfortunately, however, the success rates of BIPs are questionable (Aldarondo, 2002; Gondolf, 2002) and we do not know what factors of the program facilitate decreases in abusive behavior when this does occur. Specifically, it is unknown whether and how individual characteristics interact with intervention group dynamics to facilitate change. To better understand this gap in the literature, this study investigated the relationship between social support, group majority-minority status, and interpersonal dependency in predicting intimate partner violence. The study utilizes data collected for a larger study sampling 180 men enrolled in a batterer intervention program in Portland, Oregon. It was hypothesized that partner violence is positively related to interpersonal dependency and negatively related to group social support. Furthermore, it was hypothesized that majority-minority group status moderates the relationship between group social support and intimate partner violence. As predicted, men who were more dependent on their partners also reported higher levels of psychological aggression perpetrated against their partners during the past 6-months. However, this relationship did not exist between interpersonal dependency and conflict tactics related to physical assault, injury, or sexual coercion. Further, perceived social support in the group did not predict partner violence as hypothesized. However, among men who had attended nine or fewer BIP sessions, both group social support and interpersonal dependency were positively associated with psychological aggression. Finally, among men who were involved in an intimate relationship at the time of data collection, interpersonal dependency was positively related to psychological aggression and physical assault. Title: The relationship of group support, majority status, and interpersonal dependency in predicting intimate partner violence Author: Gray, Mary Elisabeth Year: 2009 One of the most common community responses to intimate partner violence is batterer intervention programs (BIPs), which are aimed at ending perpetrators' violent behavior. Unfortunately, however, the success rates of BIPs are questionable (Aldarondo, 2002; Gondolf, 2002) and we do not know what factors of the program facilitate decreases in abusive behavior when this does occur. Specifically, it is unknown whether and how individual characteristics interact with intervention group dynamics to facilitate change. To better understand this gap in the literature, this study investigated the relationship between social support, group majority-minority status, and interpersonal dependency in predicting intimate partner violence. The study utilizes data collected for a larger study sampling 180 men enrolled in a batterer intervention program in Portland, Oregon. It was hypothesized that partner violence is positively related to interpersonal dependency and negatively related to group social support. Furthermore, it was hypothesized that majority-minority group status moderates the relationship between group social support and intimate partner violence. As predicted, men who were more dependent on their partners also reported higher levels of psychological aggression perpetrated against their partners during the past 6-months. However, this relationship did not exist between interpersonal dependency and conflict tactics related to physical assault, injury, or sexual coercion. Further, perceived social support in the group did not predict partner violence as hypothesized. However, among men who had attended nine or fewer BIP sessions, both group social support and interpersonal dependency were positively associated with psychological aggression. Finally, among men who were involved in an intimate relationship at the time of data collection, interpersonal dependency was positively related to psychological aggression and physical assault. Close

• 30. [Article] Diagnostic congruence: a study on presentation of clinical information to parents and recall

  The present study was an investigation of recall following presentation of diagnostic information. The setting was the Crippled Children's Division of the University of Oregon Medical School. The purpose ...

  Citation × Citation Citation Abstract Copy Title: Diagnostic congruence: a study on presentation of clinical information to parents and recall Author: Maier, Miriam Rae Year: 1972 The present study was an investigation of recall following presentation of diagnostic information. The setting was the Crippled Children's Division of the University of Oregon Medical School. The purpose of the study was to test the hypothesis that one session conferencing imparting diagnostic information to parents of handicapped children reduces recall. Additionally, it was hypothesized that multi-discipline conferencing is related to greater diagnostic recall than single discipline conferencing. The sample was made up of 20 parent units whose children were evaluated at the Crippled Children's Division for suspected Cerebral Palsy and/or Mental Retardation. There were ten families from the Cerebral Palsy Clinic and ten from the Mental Retardation Clinic. Three comparisons were made: (1) The amount of information presented at the staffing session was the baseline against which the amount of information imparted at the parent conference was compared. (2) The amount of information imparted at the parent conference was compared with the amount of information that was recalled six weeks later at the follow up interview. (3) The amount of information recalled at the time of the follow up interview was compared with the staffing information in order to determine the loss of diagnostic information. The results supported the hypotheses. Diagnostic congruence was by far, more the exception than the rule Implications suggest that additional follow up services are necessary. Title: Diagnostic congruence: a study on presentation of clinical information to parents and recall Author: Maier, Miriam Rae Year: 1972 The present study was an investigation of recall following presentation of diagnostic information. The setting was the Crippled Children's Division of the University of Oregon Medical School. The purpose of the study was to test the hypothesis that one session conferencing imparting diagnostic information to parents of handicapped children reduces recall. Additionally, it was hypothesized that multi-discipline conferencing is related to greater diagnostic recall than single discipline conferencing. The sample was made up of 20 parent units whose children were evaluated at the Crippled Children's Division for suspected Cerebral Palsy and/or Mental Retardation. There were ten families from the Cerebral Palsy Clinic and ten from the Mental Retardation Clinic. Three comparisons were made: (1) The amount of information presented at the staffing session was the baseline against which the amount of information imparted at the parent conference was compared. (2) The amount of information imparted at the parent conference was compared with the amount of information that was recalled six weeks later at the follow up interview. (3) The amount of information recalled at the time of the follow up interview was compared with the staffing information in order to determine the loss of diagnostic information. The results supported the hypotheses. Diagnostic congruence was by far, more the exception than the rule Implications suggest that additional follow up services are necessary. Close