Computerized encounter registers in primary care research: Is there a gold standard?

Computer technology as well as the need to conduct research in primary care settings, has stimulated the creation in the U.S. of information networks linking private physicians' offices and other primary care practice sights. These networks give rise to several problems which have philosophic interest. One is a “numerator problem” created by the difficulty in primary care of using the more complicated or invasive diagnostic technologies commonly employed in tertiary care research. Another is a “denominator problem” arising from the difficulties in determining which and how many patients constitute the population from which a practice is drawn. Finally, this mode of research raises questions about the social construction of medical reality and how “objective” medical truth is actually based on carefully selected patient experience. All these questions combine to challenge the “gold standard” view on medical research: the idea that some sorts of medical knowledge are epistemologically privileged and can serve as a bench-mark to determine whether new data are valid.     

Is there a sensitive period in human incest avoidance?

Many studies support the proposition that early cosocialization with opposite-sex children has the effect of inhibiting later mutual sexual attraction, but the existence of a period in the life cycle in which individuals are sensitive to the effect of early cosocialization has been a matter of controversy. Drawing on earlier traditional psychological research, and on more recent work guided by parental investment theory, we hypothesized that only for maternal perinatal association (MPA)-absent males a less-than- around-three-years age difference with the sister can predict stronger aversion to sibling incest. The results corroborated the hypothesis. The results can be interpreted as support for the existence of a sensitive period as well as for the potent role of MPA. Cross-cultural comparative studies were called on to further test the hypothesis.     

Marital satisfaction in covenant versus standard marriages: Is there a difference?

After the rapid increase of the American divorce rate in the late 20th century, one of the most conspicuous efforts of the marriage movement in the 1990s that was used to increase marital stability was the legislation of the covenant marriage license, a more restricted marriage license issued in three different states of the U.S. To investigate the marital life of newlywed covenant versus standard couples, a large-scale 5-year couple study was conducted between 1998 and 2003 in Louisiana. The present study uses this large-sample, multiple-wave, multiple-group dyadic dataset to examine differences in co-development and divorce rates in 297 covenant and 380 standard mixed-sex couples using a multiple group growth curve modeling and survival analysis. We examined differences in marital trajectories between covenant and standard couples as well as between husbands and wives in each marital group. The results show (1) that the couples in both groups experienced, on average, declines in marital satisfaction, and such a decline was slower in covenant husbands than their wives as well as those in standard marriages, and (2) that co-development in marital satisfaction was more prominent in standard marriages than in covenant marriages, meaning standard couple's marital satisfaction declined at a more similar rate than that of covenant couples. We provide possible explanations and discuss practical implications.     

Is the human mind a Turing machine?

In this paper I discuss the topics of mechanism and algorithmicity. I emphasise that a characterisation of algorithmicity such as the Turing machine is iterative; and I argue that if the human mind can solve problems that no Turing machine can, the mind must depend on some non-iterative principle — in fact, Cantor's second principle of generation, a principle of the actual infinite rather than the potential infinite of Turing machines. But as there has been theorisation that all physical systems can be represented by Turing machines, I investigate claims that seem to contradict this: specifically, claims that there are noncomputable phenomena. One conclusion I reach is that if it is believed that the human mind is more than a Turing machine, a belief in a kind of Cartesian dualist gulf between the mental and the physical is concomitant.     

Is a pre-change object representation weakened under correct detection of a change?

We investigated whether a pre-change representation is inhibited or weakened under correct change detection. Two arrays of six objects were rapidly presented for change detection in three experiments. After detection, the perceptual identification of degraded stimuli was tested in Experiments 1 and 2. The weakening of a pre-change representation was not observed under correct detection. The repetition priming effect was observed for a pre-change object and the magnitude was equivalent to the effect for a post-change object. Under change blindness, repetition priming for a pre-change representation was observed when detection did not require report of location in Experiment 1 and was not observed when location was required to be reported in Experiment 2. The results of Experiment 3 showed that a pre-change representation was recognized at a higher rate under correct detection than under change blindness, reflecting a stronger rather than a weaker pre-change representation in the former context.     

Is obsessive-compulsive disorder caused by a second-messenger imbalance?

Although the precise etiologic nature of obsessive-compulsive disorder (OCD), one of the most common psychiatric conditions, is unknown, several findings indicate involvement of the serotonin (5-HT) transporter. Apart from the specific effects of selective 5-HT reuptake inhibitors, other studies show decreased functionality of the platelet 5-HT transporter in OCD. In this report, the authors combine data from two independent studies of patients with OCD, showing both an increased activity of protein kinase type C (PKC) and a decreased activity of protein kinase type A (PKA). The authors propose a unifying hypothesis that OCD might be determined by an imbalance between PKC and PKA, with a prevalence of the former and, more generally, of the phosphoinositide over the cyclic adenosine monophosophate (cAMP) pathway. Should this hypothesis prove correct, the path would be open for new therapeutic interventions in the treatment of OCD.     

Is there a religious factor in health?

This paper reviews epidemiologic studies employing religion as an independent construct, and finds that most epidemiologists have an extremely limited appreciation of religion. After a historical overview of empirical religion and health research, some theoretical considerations are offered, followed by clarification of several operational and methodological issues. Next, well over 200 studies are reviewed from nine health-related areas: cardiovascular disease, hypertension and stroke, colitis and enteritis, general health status, general mortality, cancer of the uterine corpus and cervix, all other non-uterine cancers, morbidity and mortality in the clergy, and cancer in India. Finally, an agenda for further research is proposed.     

Is there a magnitude effect in tipping?

The present study examined nearly 1,000 tips recorded for two taxicabs, two hair salons, and two restaurants. In each of the six cases, amount of tip increased linearly as a function of the amount of the bill. Contrary to standard microeconomic theory, there was a magnitude effect in that as the amount of the bill increased, the percent tip tended to decrease. The present results extend the findings of Chapman and Winquist (1998), obtained using hypothetical scenarios, to real-world tipping behavior. Chapman and Winquist argued that a magnitude effect in tipping reflects the shape of the utility function for money. We suggest, however, that the magnitude effect may be the mathematical consequence of replotting the fundamental relationship between tip and bill amounts in terms of percent tip, given that the observed linear relation between tip and bill amounts has a positive intercept. We suggest further that the positive intercept arises because a tip represents a judgment as to what constitutes a fair or equitable wage, and part of what constitutes a fair wage is independent of the amount of the bill, reflecting compensation for simply being there when needed. The present account implies that different explanations may be needed for magnitude effects observed in different domains.     

Is there a chaplain in your clinic?

As medical care continues to move outside the hospitals, clients with spiritual needs are more often to be found in clinics and doctors' offices than inpatient settings. Chaplains in partnership with physicians can contribute to healing in outpatient centers. A study of one group of clinic patients indicates that an outpatient setting may be a better place to address spiritual needs than a hospital setting. Pastoral interventions are acceptable to many clients, who according to statistics are already using alternative therapies to augment traditional medical care. Paul A. Mandziuk, M. Div., a priest of the Missionaries of La Salette, is a chaplain at Saint Louis University Health Sciences Center in St. Louis, MO, and serves on the leadership council of the National Association of Catholic Chaplains.     

Is Phonological Encoding in Naming Influenced by Literacy?

We examined phonological priming in illiterate adults, using a cross-modal picture-word interference task. Participants named pictures while hearing distractor words at different Stimulus Onset Asynchronies (SOAs). Ex-illiterates and university students were also tested. We specifically assessed the ability of the three populations to use fine-grained, phonemic units in phonological encoding of spoken words. In the phoneme-related condition, auditory words shared only the first phoneme with the target name. All participants named pictures faster with phoneme-related word distractors than with unrelated word distractors. The results thus show that phonemic representations intervene in phonological output processes independently of literacy. However, the phonemic priming effect was observed at a later SOA in illiterates compared to both ex-illiterates and university students. This may be attributed to differences in speed of picture identification.     

Is Pogge a Capability Theorist in Disguise?

Thomas Pogge answers the question if the capability approach can be justified with a firm ‘no’. Amongst others, he ridicules capability theorists for demanding compensation for each and every possible natural difference between people, including hair types. Not only does Pogge, so this paper argues, misconstrue the difference between the capability approach and Rawlsian resourcism. Even worse: he is actually implicitly relying on the idea of capabilities in his defence of the latter. According to him the resourcist holds that the institutional order should not be biased towards the average person or the needs of some. Yet, as his own case of blind people and traffic lights can illustrate, whether or not this is the case is impossible to assess without resorting to some concept like people’s capabilities. Secondly, it is argued that the real issue at stake is not at all the best metric of justice—primary goods or capabilities—but rather the scope of theories of justice. On the surface the difference of opinion seems to be how to deal with so-called “personal heterogeneities”, yet the discussed case of interpersonal differences in metabolism and communal land-use choices hints at something else; Whereas Pogge insists that questions of justice only concern the institutional structure of society, many capability theorists support the inclusion of culture and social practices as possible sources of injustice. Unfortunately Pogge does not properly acknowledge this, as right from the start of his paper he frames the debate between both approaches in terms of institutions only.     

Is Detecting a Target in a Compound Geometric Shape Influenced by Stimulus Density? A Developmental Study

We studied the pattern of performance in elementary school children and adults detecting a target in compound geometric shapes. The target was randomly presented at the global, local, or neither level of compound shapes with different elemental density. A significant difference between the pattern of performance in children and adults emerged when the geometric shape was constructed with fewer constituent parts. That is, children showed difficulties in recognizing the global level while adults could efficiently process it. We suggest that global processing continues to develop as children grow older. Also, integration ability could benefit from increasing familiarity with the geometric concepts.     

Are preferences in emotional processing affected by distraction? Examining the age-related positivity effect in visual fixation within a dual-task paradigm

Recent research has suggested that age-related positivity effects are eliminated under conditions of dual-task load (Knight et al., 2007, Emotion, 7, 705; Mather & Knight, 2005, Psychology and Aging, 20, 554), because the cognitive control resources necessary to enact such preferences are not available when individuals are distracted by competing information. We further examined how older adults' emotional information processing preferences are affected by distracting information by utilizing a within-subjects dual-task measure. Younger and older adults viewed a series of positive, negative, and neutral images both in conditions of full and divided attention. Fixation preferences to valenced images were assessed through eye tracking. Regardless of whether images were viewed in full or divided attention conditions, older adults demonstrated a preference in their fixation for positive and neutral in comparison to negative images. These results provide evidence that older adults' positive fixation preferences may not always necessitate full, cognitive control.     

Is verbal–spatial binding in working memory impaired by a concurrent memory load?

Binding processes play a critical role in memory. We investigated whether the binding of (visually presented) verbal and spatial (locations) information involves general attentional resources, as stipulated in the revised working memory model, by comparing measures of binding in the presence and absence of a concurrent memory load. Using an adaptation of a probe recognition task contrasting performance between intact and recombined conditions, we found that the concurrent retention of a sequence of three pure tones eliminated verbal–spatial binding. The present study constitutes the first to directly measure the impact of a concurrent memory load on verbal–spatial binding and suggests that such binding may indeed recruit attentional resources, consistent with some recent findings in the visual–spatial binding literature.     

Is object texture a constraint on human prehension?: kinematic evidence

The present experiment determined whether object texture influenced the transport and grasp components of human prehension. Infrared markers placed on the index finger, thumb, and wrist were recorded using a WATSMART system. The test objects were cylindrical dowels (103 mm high, 25 mm diameter, and 150 g in weight) of various surface materials (plain metal, coated with Vaseline, and covered with coarse sandpaper). Only temporal kinematic measures were affected by texture: Movement time (ms), time after peak deceleration (ms), percentages of movement time following maximum aperture, velocity, and deceleration were all significantly greater for the slippery dowel than the normal and rough dowels. Results indicated that the increased time associated with the slippery dowel could be explained entirely by increased time between contact with the dowel and dowel lift. Thus, these results are like those of Weir, MacKenzie, Marteniuk, Cargoe, and Frazer (1991), in which object weight was shown not to affect the free-motion phase, which includes the transport and grasp components of prehension. It appears that intrinsic object properties like weight and texture affect only the finger-object interaction phase of prehension; subsequent research is needed to dissociate inertial and surface friction effects while in contact with objects     

Is there a place for Feminists in a Christian Church?

Based on a dialogue held on 16 May 1986 in London at Westminster Cathedral Hall, and organised by Catholic Women's Network and Women in Theology. Dr Daphne Hampson presents her own position at length, Dr Rosemary Ruether responds to it at length, and a discussion between the two of them follows.