Signification,Intention, Projection

Locke is what present-day aestheticians, critics, and historians call an intentionalist. He believes that when we interpret speech and writing, we aim—in large part and perhaps even for the most part—to recover the intentions, or intended meanings, of the speaker or writer. Berkeley and Hume shared Locke’s commitment to intentionalism, but it is a theme that recent philosophical interpreters of all three writers have left largely unexplored. In this paper I discuss the bearing of intentionalism on more familiar themes in empiricist reflections on language, among them the signification of things (as opposed to ideas); the signifying role of whole propositions; and the possibility of reference to an “external” world.

Combining Patient Utility with Health Status Assessment to Improve Medical Decision Making

Physicians often use health status assessment tools to evaluate a patient's condition, then apply established guidelines to determine the most medically effective treatment. Yet additional criteria, such as the appropriateness of the treatment given the particular patient's preferences and attitude toward risk, are also highly relevant to quality care. While such preferences could be addressed via patient utility functions, their use in actual practice is somewhat limited because elicitation is often considered too burdensome for patients, unreliable, or redundant given other measures. For a small group of real patients who have suffered a stroke, we measure both traditional health status and patient utility for the current state to determine whether limited, focused utility assessment is a practical means of obtaining additional and relevant patient information. We find that utility assessment is perceived as reasonable and useful by patients, even when quite ill, and that utilities and health status are not redundant. In fact, investigating apparent inconsistencies between patient utility and observed health status can alert the physician to patient concerns and criteria not captured by more traditional measures. We propose an approach to medical decision making that uses both measures to improve patient–physician communication.     

“My Plate is Full”: Reasons for Declining a Genetic Evaluation of Hearing Loss

The aim of this study was to obtain patient and parent perspectives on genetic evaluation of hearing loss, in order to identify motivators, expectations, and barriers. Three focus groups were conducted following a semi-structured discussion guide, led by an independent moderator. Participants were hearing parents of children with permanent hearing loss or deaf adults. Qualitative content analysis was used to develop a codebook and identify major themes and subthemes. Participant views were compared to national guidelines. The 28 participants comprised 23 parents representing 21 unique families and 5 deaf adults. 13/21 families and 0/5 adults reported comorbidities, 4/21 families and 3/5 adults had a positive family history, and 12/21 families versus 0/5 adults had utilized genetics services. A common theme among adults and parents was a curiosity as to the cause of hearing loss. Parents were motivated to detect comorbidities and optimize care for hearing loss. Some parents felt overwhelmed by the hearing loss and unprepared to pursue early genetic evaluation as recommended in guidelines. Several reported positive experiences following genetics consultation, while others reported unease and unmet expectations. Notably, both parents and adults expressed ambivalence regarding the desire for genetic knowledge. Financial concerns and difficulties obtaining a referral were cited as extrinsic barriers. For parents of children with hearing loss, both the presence of comorbidities and a positive family history were drivers of genetics consultation and/or genetic testing. We identified educational opportunities for both patients and providers that would improve informed decision-making and increase access to genetic services. Consideration of the patient/family perspective and their decision-making processes, along with flexibility in the approach to genetics evaluation and its timing, will optimize both the development and implementation of guidelines.     

Preference,Expectations, and Attributional Bias: Two Field Studies1

Two quasi-experiments were conducted to test the relationship among a perceiver's preference, expectations, and causal attributions for an event, when the outcome of the event ran for and counter to expectation and preference. Following the 1976 Superbowl, fans of Dallas and Pittsburgh and fans with no preference were asked to attribute causality for a series of game events, counterbalanced for (un)favorability for each team. Following the 1976 Presidential election, fans of Carter and Ford were asked to attribute causality for the election outcome and estimate its repeatability and mutability. Both studies revealed that fans exhibit a biased attributional pattern, offering more credit to their own side for their successes than to the opponents for their successes. Furthermore, fans see their side's successes as replicable and their side's failures as nonreplicable. The implications of the data patterns for real world manifestations of attributional bias are discussed.     

Some Concomitants of Underachievement at the Elementary School Level

This study compared a group of fourth-grade underachieves with a control group in the areas of peer relationships and measured personality variables. The underachievers were identified by predicting their grade-point average (GPA) from their WISC Verbal Scale IQ score by use of a prediction equation. If the predicted GPA was .8 standard error of estimate above their obtained GPA, the student was identified as an underachiever. This resulted in the identification of 84 male and 34 female underachievers. The results of the investigation indicated that regardless of sex, underachievers are selected less frequently by their peers and have a lower level of personality adjustment.     

Depression and Anxiety: Integrating the Tripartite and Cognitive Content-Specificity Assessment Models

The cognitive content-specificity hypothesis proposes that depression and anxiety can be discriminated on the basis of unique cognitive profiles. Alternatively, the Tripartite model suggests that, although depression and anxiety share a general distress factor, anhedonia is a characteristic of depression with anxious arousal a characteristic of anxiety. Past research devoted to integrating these two models has been limited in a number of ways. To remedy these limitations, this study attempted to assess the complete Tripartite model and used a multidimensional cognitive assessment tool to handle the heterogeneity of anxious cognitive content. Results on data collected from 411 clients seeking services at a university counseling center suggested that a one-to-one mapping between Tripartite dimensions and cognitive content was possible. Further, variables from each model simultaneously explained unique variance in depression and anxiety ratings.     

Nietzsche and l’élan technique: Technics,life, and the production of time

Abstract In this paper we examine Nietzsche’s relation to the life sciences of his time and to Darwinism in particular, arguing that his account of the will to power in terms of technics eschews three metaphysical prejudices, hylemorphism, utilitarianism, and teleological thinking. Telescoping some of Nietzsche’s pronouncements on the will to power with a Bergsonian lens, our reading of the will to power, as an operation productive of time, the future or life, offers an alternative to Heidegger’s. Rather than being reducible to a technics of domination or mastery, the will to power, we argue, is best interpreted as a technics of material forces that recasts all things past and future, near and far, moment by moment.     

Pre-attentive auditory processing of lexicality

The effects of lexicality on auditory change detection based on auditory sensory memory representations were investigated by presenting oddball sequences of repeatedly presented stimuli, while participants ignored the auditory stimuli. In a cross-linguistic study of Hungarian and German participants, stimulus sequences were composed of words that were language-familiar, lexical, meaningful in Hungarian but language-unfamiliar, not lexical, meaningless in German, and words with the opposite characteristics. The roles of frequently presented stimuli (Standards) and infrequently presented one (Deviants) were fully crossed. Language-familiar and language-unfamiliar Deviants elicited the Mismatch Negativity component of the event-related brain potential. We found differences in processes of change detection depending on whether the Standard was language-familiar, or not. Whereas, the lexicality of the Deviant had no effect on the processes of change detection. Also, language-familiar Standards processed differently than language-unfamiliar ones. We suggest that pre-attentive (default) tuning to meaningful words sets up language-specific preparatory processes that affect change detection in speech sequences.