Event-learning and robust policy heuristics

In this paper we introduce a novel reinforcement learning algorithm called event-learning. The algorithm uses events, ordered pairs of two consecutive states. We define event-value function and we derive learning rules. Combining our method with a well-known robust control method, the SDS algorithm, we introduce Robust Policy Heuristics (RPH). It is shown that RPH, a fast-adapting non-Markovian policy, is particularly useful for coarse models of the environment and could be useful for some partially observed systems. RPH may be of help in alleviating the ‘curse of dimensionality’ problem. Event-learning and RPH can be used to separate time scales of learning of value functions and adaptation. We argue that the definition of modules is straightforward for event-learning and event-learning makes planning feasible in the RL framework. Computer simulations of a rotational inverted pendulum with coarse discretization are shown to demonstrate the principle.     

Building Alliances with (In)Voluntary Clients: A Study Focused on Therapists’ Observable Behaviors

This study aimed to compare therapists’ observable behaviors to promote alliances with involuntary and voluntary clients during brief family therapy. The therapists’ contributions to fostering alliances were rated in sessions 1 and 4 using videotapes of 29 families who were observed in brief therapy. Using the System for Observing Family Therapy Alliances, trained raters searched for specific therapist behaviors that contributed to or detracted from the four alliance dimensions: engagement in the therapeutic process, an emotional connection with the therapist, safety within the therapeutic system, and a shared sense of purpose within the family. The results showed that when working with involuntary clients, therapists presented more behaviors to foster the clients’ engagement and to promote a shared sense of purpose within the family. However, in the fourth session, the therapists in both groups contributed to the alliance in similar ways. The results are discussed in terms of (a) the therapists’ alliance‐building behaviors, (b) the specificities of each client group, and (c) the implications for clinical practice, training, and research.     

The Defeasibility of Knowledge‐How

Reductive intellectualists (e.g., Stanley & Williamson 2001; Stanley 2011a; 2011b; Brogaard 2008; 2009; 2011) hold that knowledge‐how is a kind of knowledge‐that. If this thesis is correct, then we should expect the defeasibility conditions for knowledge‐how and knowledge‐that to be uniform—viz., that the mechanisms of epistemic defeat which undermine propositional knowledge will be equally capable of imperilling knowledge‐how. The goal of this paper is twofold: first, against intellectualism, we will show that knowledge‐how is in fact resilient to being undermined by the very kinds of traditional (propositional) epistemic defeaters which clearly defeat the items of propositional knowledge which intellectualists identify with knowledge‐how. Second, we aim to fill an important lacuna in the contemporary debate, which is to develop an alternative way in which epistemic defeat for knowledge‐how could be modelled within an anti‐intellectualist framework.     

Neuropsychological Measures that Predict Progression from Mild Cognitive Impairment to Alzheimer's type dementia in Older Adults: a Systematic Review and Meta-Analysis

This study aimed to determine the extent to which cognitive measures can predict progression from mild cognitive impairment (MCI) to Alzheimer’s type dementia (AD), assess the predictive accuracy of different cognitive domain categories, and determine whether accuracy varies as a function of age and length of follow-up. We systematically reviewed and meta-analyzed data from longitudinal studies reporting sensitivity and specificity values for neuropsychological tests to identify individuals with MCI who will develop AD. We searched articles in Medline, Cochrane, EMBASE, PsycINFO, and the Web of Science. Methodological quality was assessed using the STARDem and QUADAS standards. Twenty-eight studies met the eligibility criteria (2365 participants) and reported predictive values from 61 neuropsychological tests with a 31-month mean follow-up. Values were pooled to provide combined accuracy for 14 cognitive domains. Many domains showed very good predictive accuracy with high sensitivity and specificity values (≥ 0.7). Verbal memory measures and many language tests yielded very high predictive accuracy. Other domains (e.g., executive functions, visual memory) showed better specificity than sensitivity. Predictive accuracy was highest when combining memory measures with a small set of other domains or when relying on broad cognitive batteries. Cognitive tests are excellent at predicting MCI individuals who will progress to dementia and should be a critical component of any toolkit intended to identify AD at the pre-dementia stage. Some tasks are remarkable as early indicators, whereas others might be used to suggest imminent progression.     

Parents of Adults with Intellectual and Developmental Disabilities (IDD) and Compound Caregiving Responsibilities

In some cases, parents caring for an adult child with an intellectual and/or developmental disability (IDD) must balance this with caregiving for another family member. This dual responsibility, referred to as “compound caregiving”, may contribute to increased feelings of distress, or change their perceived ability to care for their child. The current study examined how compound caregivers differ from other parents of adults with IDD, and whether compound caregiving is significantly associated with family distress. Data was available for 199 parents aged 38 to 91 years who were seeking adult services for their son or daughter with IDD. Parents completed a mailed questionnaire and telephone interview in which they indicated compound caregiver responsibilities. Parents identified as compound caregivers were then compared to those who were not in terms of family characteristics, as well as parental perceptions of burden and mastery, and family distress as measured by the Revised Caregiver Appraisal Scale and the Brief Family Distress Scale, respectively. Nearly half of the parents reported being compound caregivers. The demographic profile of these parents was no different from that of the other parents but their children were slightly younger. Compound caregiving was significantly associated with parental perceptions of burden and mastery and family distress. Demands outside of caring for an adult child with IDD can negatively influence family functioning and must be included as part of caregiving assessments.     

Service Delivery Outcomes in ASD: Role of Parent Education,Empowerment, and Professional Partnerships

Children with Autism Spectrum Disorder (ASD) utilize a greater number of healthcare services compared to children with other developmental disabilities. Despite this, children with ASD remain at high risk for unmet service needs, which are compounded by differences in socioeconomic status (SES). Both empowerment and parent-professional partnership play a role in service outcomes and may be especially important in understanding these service disparities. Our goal was to better understand the contributions of these variables to service disparities in families of children with ASD. Two-hundred forty-nine parents of children with ASD between the ages of 3 and 20 participated in this online survey. Results support previous research highlighting high levels of unmet needs that are exacerbated by differences in parent education, a common indicator of SES. Empowerment and parent-professional partnership also predicted service delivery outcomes. While high quality partnership predicted greater service adequacy, empowerment was inversely related to services. Furthermore, an interaction found that highly empowered families experiencing poor quality partnerships reported worse service delivery outcomes, while empowerment was not a factor in services for families experiencing high quality partnerships. Parent-professional partnership partially mediated the relationship between parent education and service delivery outcomes. As such, increasing parent-professional partnerships through family-centered care and professional training may help to reduce education-related service disparities and improve satisfaction with care for families and children with ASD.     

The influences and outcomes of phonological awareness: a study of MA,PA and auditory processing in pre‐readers with a family risk of dyslexia

The direct influence of phonological awareness (PA) on reading outcomes has been widely demonstrated, yet PA may also exert indirect influence on reading outcomes through other cognitive variables such as morphological awareness (MA). However, PA's own development is dependent and influenced by many extraneous variables such as auditory processing, which could ultimately impact reading outcomes. In a group of pre‐reading children with a family risk of dyslexia and low‐risk controls, this study sets out to answer questions surrounding PA's relationship at various grain sizes (syllable, onset/rime and phoneme) with measures of auditory processing (frequency modulation (FM) and an amplitude rise‐time task (RT)) and MA, independent of reading experience. Group analysis revealed significant differences between high‐ and low‐risk children on measures of MA, and PA at all grain sizes, while a trend for lower RT thresholds of high‐risk children was found compared with controls. Correlational analysis demonstrated that MA is related to the composite PA score and syllable awareness. Group differences on MA and PA were re‐examined including PA and MA, respectively, as control variables. Results exposed PA as a relevant component of MA, independent of reading experience.     

“Big eye” surgery: the ethics of medicalizing Asian features

The popularity of surgical modifications of race-typical features among Asian women has generated debates on the ethical implications of the practice. Focusing on blepharoplasty as a representative racial surgery, this article frames the ethical discussion by viewing Asian cosmetic surgery as an example of medicalization, which can be interpreted in two forms: treatment versus enhancement. In the treatment form, medicalization occurs by considering cosmetic surgery as remedy for pathologized Asian features; the pathologization usually occurs in reference to western features as the norm. In the enhancement form, medicalization occurs by using medical means to improve physical features to achieve a certain type of beauty or physical appearance. Each type of medicalization raises slightly different ethical concerns. The problem with treatment medicalization lies in the pathologization of Asian features, which is oppressive as it continues to reinforce racial norms of appearance and negative stereotypes. Enhancement medicalization is ethically problematic because cosmetic surgery tends to conflate beauty and health as medical goals of surgery, overemphasizing the value of appearance that can further displace women’s control over their own bodies. I conclude that in both forms of medicalization, cosmetic surgery seems to narrowly frame a complex psychosocial issue involving physical appearance as a matter that can be simply solved through surgical means.