The importance of a holistic concept of health for health care. Examples from the clinic

One of my main points in this study is that the knowledge of orthodox medical theory is an incomplete guide for practical action when relating to our patients' specifically human problems. By following a holistic perspective on patients' health and on our medical enterprise we will be more efficient as doctors. This standpoint is illuminated by means of two case reports. Instead of focusing on symptoms as such and letting them refer to orthodox medical theory, I explicitly relate to the patients as if they are conveying a personal meaning by means of experienced symptoms. The experience of illness could be a successful strategy on the existential level although destructive on the technical biological level. A holistic theory of health can give doctors a good conceptual base when relating to people whose presented illnesses are to be regarded explicitly as their way of making themselves understood. The doctor's understanding of the patient's illness, of the theory of health, and of how health is regained, is dependent on the doctor's having the courage to reduce the distance to the patient, the courage to participate and be changed.     

Perceived numerosity of spatiotemporal events

Numerosity discrimination was examined when items were varied in space-time position rather than in space only. Observers were instructed to indicate which of two adjacent streamsof visual events contained more items. The precision of numerosity discrimination of dynamic events was not remarkably different from that of static patterns. Two basic numerosity biases previously found for static dot patterns—inhibitory overestimation and satellite underestimation—were demonstrated for items distributed randomly over a spatiotemporal interval. It was also demonstrated that two streams, equated in the number and luminous energy of items, are not judged equal in their visible number if items in one of these two streams have longer duration than items in the second stream. These findings can be accounted for by the occupancy model of perceived numerosity (Allik & Tuulmets, 1991a) if it is supposed that the impact that each element has on its neighborhood is spread along both spatial and temporal coordinates. Perceived numerosity decreases with both spatial and temporal proximity between the-visual-items. Space and time have interchangeable effects on perceived numerosity: the amount of numerosity bias caused by the spatial proximity of items can also be produced by the properly chosen temporal proximity of items     

Additivity of loudness across critical bands: A critical test

The use of magnitude estimation as well as axiomatic measurement theory has led to the suggestion that loudness adds across critical bands. In the present paper, we challenge this postulate by applying a more sensitive methodology, based on Falmagne’s (1976) random conjoint measurement procedure. A necessary condition for additivity of loudness was investigated in tone complexes consisting of 2-kHz and 5-kHz (resp. 3-kHz) components; the results showed systematic deviations from additivity. We argue that these deviations are due to asymmetric masking of the higher component by the lower one, and we propose a tentative quantitative model to account for the data. Such a model is in line with results from tone-on-tone masking, which show masking to be effective over a range of several critical bands.     

Behavior at 10 and 13 years of age for children with low birth weight

This study was based on data from a longitudinal research program. The cohort consisted of 874 normal children in an entire school grade in a Swedish community. The aim of the study was to investigate the relation between birth weight and behavior at school, for all children and for each sex separately. The results identified specific aspects of behaviour disorder significantly related to low birth weight (LBW) for children at the age of 10 but not at the age of 13. When the sexes were separated, there were no relations between birth weight and deviant behaviour for boys of low birth weight as compared to boys of normal birth weight, while girls of low birth weight showed specific behavioural disorders at age 10 as compared to girls of normal birth weight. For girls reared in families of low parental socioeconomic status, aggressiveness and motor restlessness at age 10 but not at age 13 was also present. Further analyses showed that girls born small-for-gestational age showed lack of school motivation and concentration difficulties both at age 10 and age 13.     

Neuroleptic malignant syndrome--3 case reports

An account is given of three patients who exhibited a malignant neuroleptic syndrome after the administration of neuroplegics. Like other authors, we identified typical elicitation factors and clinical characteristics. In one case a catatonic dilemma with lethal issue was observed. In the final case dealt with in this paper, the renewed application of neuroplegics following the termination of the malignant neuroleptic syndrome was tolerated without complications, whereas in the case of an epileptic patient with damage to the brain, the malignant neuroleptic syndrome returned upon dosage increase.     

Questions at the general hospital. Ulcerative colitis and Crohn disease in the light of a discussion on the body and soul

The author is an internist in a non-university hospital. He discusses the possibilities and limits of dealing with patients suffering from ulcerative colitis and Crohn's disease. He demonstrates the clinical importance of a psychoanalytic perspective with three case illustrations.     

Some properties of estimated scale invariant covariance structures

Scale invariance is a property shared by many covariance structure models employed in practice. An example is provided by the well-known LISREL model subject only to classical normalizations and zero constraints on the parameters. It is shown that scale invariance implies that the estimated covariannce matrix must satisfy certain equations, and the nature of these equations depends on the fitting function used. In this context, the paper considers two classes of fitting functions: weighted least squares and the class of functions proposed by Swain.Constructive comments by the referees are greatly appreciated. The author gratefully acknowledges Michael Browne's interest in his work.     

Toward a Process Analysis of Emotions: The Case of Surprise

Based on an earlier model of the processes elicited by surprising events, the present studies provide evidence for one of these processes, the evaluation of the surprising event's relevance for ongoing activities (action-relevance check). The central prediction tested was that, if unexpected events elicit among other processes an action-relevance check, then response delay on a concurrent task will be more pronounced in a condition where this process is more elaborate and hence takes more time. In accord with this prediction, Experiment 1 found that an unexpected appearance change of the imperative stimulus in a choice reaction time (RT) task caused greater response delay than an equivalent appearance change of a distractor stimulus. Experiment 2 replicated this finding and tested several additional predictions that concerned the effects on response delay of a second appearance change of either the imperative or the distractor stimuli. These predictions, which were also mostly confirmed, were derived by combining the logic underlying the first study with the assumption that once made, appraisals of unexpected events are stored as part of the situational schema and are reused when the same or similar events reoccur leading to an abbreviation of appraisal processes. Experiment 3 once more replicated the basic finding of the previous studies and ruled out a possible alternative explanation. It is suggested that the proposed RT method of process verification may be of broader interest as a tool to study appraisal processes in emotion.     

Built Space and the Interactional Framing of Experience During a Murder Interrogation

Human interaction and communication involve space in multiple ways. This paper examines the spatial and interactional order of a covertly video-taped police interrogation. When the participants enter the interrogation room and become engaged in the interrogation process, the room itself is a constraint and a resource for interaction. While interacting within a built environment, the participants appropriate their material surroundings in ways that constitute a spatial order and make possible certain arguments. This paper examines how the physical structure of the interrogation room is differentially appropriated, used, and filled in by the participants'; territorial and postural manoeuvers over the course of their interaction; and how the spatial structures thus created by the bodily appropriation of the physical locale are subsequently formulated by talk and thereby used as a metaphorical resource to frame the participants' situated experience. Through this embedded process, the interrogators move the suspect toward confession.     

Heading and path information from retinal flow in naturalistic environments

In four experiments, we explored the heading and path information available to observers as we simulated their locomotion through a cluttered environment while they fixated an object off to the side. Previously, we presented a theory about the information available and used in such situations. For such a theory to be valid, one must be sure of eye position, but we had been unable to monitor gaze systematically; in Experiment 1, we monitored eye position and found performance best when observers fixated the designated object at the center of the display. In Experiment 2, when we masked portions of the display, we found that performance generally matched the amount of display visible when scaled to retinal sensitivity. In Experiments 3 and 4, we then explored the metric of information about heading (nominal vs. absolute) available and found good nominal information but increasingly poor and biased absolute information as observers looked farther from the aimpoint. Part of the cause for this appears to be that some observers perceive that they have traversed a curved path even when taking a linear one. In all cases, we compared our results with those in the literature.