The self-fulfilling prophecy in intensive care

Predictions of poor prognosis for critically ill patients may become self-fulfilling if life-sustaining treatment or resuscitation is subsequently withheld on the basis of that prediction. This paper outlines the epistemic and normative problems raised by self-fulfilling prophecies (SFPs) in intensive care. Where predictions affect outcome, it can be extremely difficult to ascertain the mortality rate for patients if all treatment were provided. SFPs may lead to an increase in mortality for cohorts of patients predicted to have poor prognosis, they may lead doctors to feel causally responsible for the deaths of their patients, and they may compromise honest communication with patients and families about prognosis. However, I argue that the self-fulfilling prophecy is inevitable when life-sustaining treatment is withheld or withdrawn in the face of uncertainty. SFPs do not necessarily make treatment limitation decisions problematic. To minimize the effects of SFPs, it is essential to carefully collect and appraise evidence about prognosis. Doctors need to be honest with themselves and with patients and their families about uncertainty and the limits of knowledge.     

RULES AND REASON

Wittgenstein's rule‐following considerations (PI §§185–242) have often been discussed in terms of the debate occasioned by Kripke's interpretation of the so‐called ‘paradox’ of rule‐following. In the present paper, some of the remarks that stood in the centre of that debate are looked at from a very different perspective. First, it is suggested that these remarks are, among other things, meant to bring out that, to the extent we can speak of ‘reason’ in the context of rule‐following, it is a very restricted form of reason – one which is basically to be understood as a kind of conformity. Second, by telling part of the story of the genesis of the relevant remarks it is pointed out that there is a certain tension between the ‘liberating’ character of earlier remarks bearing on rule‐following (PI §§81ff.) and the ‘sinister’ side of later remarks like §§198–202, which helps explain why it took Wittgenstein such a long time to arrive at the views expressed in his rule‐following considerations.     

Simultaneous presentation of similar stimuli produces perceptual learning in human picture processing

Human participants received unsupervised exposure to difficult-to-discriminate stimuli (e.g., A and A'), created with a morphing procedure from photographs of faces, before learning a discrimination between them. Experiments 1 and 2 demonstrated that prior exposure enhanced later discrimination and that intermixed exposure (A, A', A, A'...) resulted in better subsequent discrimination than blocked exposure (B, B, ...B', B'...). Experiments 3 and 4 showed that simultaneous exposure to 2 similar stimuli facilitated the later acquisition of both a simultaneous and a successive discrimination, and this effect was observed even though simultaneous exposure to 2 stimuli fostered the development of an excitatory association between them (Experiment 5). The findings of Experiments 1 and 2 revealed a perceptual learning effect with pictures of faces, and the findings of Experiments 3-5 are difficult to reconcile with associative analyses of perceptual learning.     

Class Size and Student Achievement

Contents:
Introduction, p.1
Quasi-Experimental Studies, p.3
Experimental and Quasi-Experimental Studies, p.15
Why Does Class Size Matter? Inferences from Existing Research, p.20
Implications of the Class-Size Findings, p.25
References, p.26
Appendix, p.29     

Perceiving affect from the voice and the face

This experiment examines how emotion is perceived by using facial and vocal cues of a speaker. Three levels of facial affect were presented using a computer-generated face. Three levels of vocal affect were obtained by recording the voice of a male amateur actor who spoke a semantically neutral word in different simulated emotional states. These two independent variables were presented to subjects in all possible permutations—visual cues alone, vocal cues alone, and visual and vocal cues together—which gave a total set of 15 stimuli. The subjects were asked to judge the emotion of the stimuli in a two-alternative forced choice task (either HAPPY or ANGRY). The results indicate that subjects evaluate and integrate information from both modalities to perceive emotion. The influence of one modality was greater to the extent that the other was ambiguous (neutral). The fuzzy logical model of perception (FLMP) fit the judgments significantly better than an additive model, which weakens theories based on an additive combination of modalities, categorical perception, and influence from only a single modality.     

Perceiving speech from inverted faces

We examined whether the orientation of the face influences speech perception in face-to-face communication. Participants identified auditory syllables, visible syllables, and bimodal syllables presented in an expanded factorial design. The syllables were /ba/, /va/, /δa/, or /da/. The auditory syllables were taken from natural speech whereas the visible syllables were produced by computer animation of a realistic talking face. The animated face was presented either as viewed in normal upright orientation or inverted orientation (180° frontal rotation). The central intent of the study was to determine if an inverted view of the face would change the nature of processing bimodal speech or simply influence the information available in visible speech. The results with both the upright and inverted face views were adequately described by the fuzzy logical model of perception (FLMP). The observed differences in the FLMP’s parameter values corresponding to the visual information indicate that inverting the view of the face influences the amount of visible information but does not change the nature of the information processing in bimodal speech perception