See me,hear me: Using film in health-care classes

This essay argues that film deserves a place within the medical humanities curriculum and demonstrates effective strategies for employing it within medical ethics and humanities classrooms. Part One of the article emphasizes how and why medical ethics teachers can utilize documentary and fictional films, such as “Thomas Szasz and the Myth of Mental Illness,” “The Deadly Deception,”Whose Life Is It Anyway? and “Voices From the Front” in their courses. Such films encourage students to move beyond abstract debates and confront the human pain inherent in all ethical dilemmas. Part Two focuses on documentary and fiction film in the medical humanities classroom. In this section, the author details how to incorporates films, such asThe Doctor, The Waterdance andHospital, into the humanities classroom, juxtaposing them with various literary works, such asOther Women's Children, Borrowed Time, andCeremony. Part Three of the essay presents a detailed discussion ofThe Elephant Man andFrankenstein, illustrating how visual and literary texts compliment each other within the humanities classroom. Overall, the author demonstrates how films function as engaging and complex visual texts providing unique insights in the particularities of American health care and, as such, can become valuable components within medical ethics and humanities classrooms.     

Globalised Religion?: The ‘parliament of the world's religions’ (Chicago 1993) in theoretical perspective

This paper tests the hypothesis that contemporary global and globalised religion as exemplified in the Chicago ‘Parliament of the World's Religions’ of 1993 may be regarded as a resource which is central, rather than marginal to current human concerns in a threatened world. The paper is structured as follows. First, a short personal narrative gives some sense of what happened at the Parliament, and how this affected one of those present. Second, as a means of conveying the scale of the meeting, a brief content analysis and interpretation of the programme shows how (within certain limits) collaboration was made possible. Third, three insights are drawn from current sociology that facilitate an informed, albeit preliminary, evaluation of the Parliament as emancipatory event. These are: i) recent globalisation theory of the world system (Roland Robertson and Peter Beyer); ii) differentiation in a social reality understood as an “economy of signs and space”; (Scott Lash and John Urry); and in) the search for “meta‐theory”; in the “condition of post‐modernity”; (David Harvey). Fourth, some implications of the analysis and interpretation are drawn out which suggest that religion can be understood as a differentiated global resource, an ambiguous, yet dynamic form of ‘cultural capital’ of vital import in an era of post‐materialist value formation. Fifth, in conclusion, it is argued that thus understood the globalised religion represented by the 1993 ‘Parliament of the World's Religions’ has wider implications for the study of contemporary religion and forms of religiosity. Religion returns from the theoretical and cultural periphery (a marginalisation promoted by traditional secularisation theory) into a close relation to the core issues of our time. This is an optimistic interpretation of an event, the significance of which, in the opinion of this writer, should not be underestimated in the evaluation of religion as global resource.     

Extraction of relief from visual motion

We quantified the ability of human subjects to discriminate the relative distance of two points from a slanted plane when viewing the projected velocities of this scene (orthographic projection). The relative distance from a plane (called relief) is a 3-D property that is invariant under linear (affine) transformations. As such, relief canin principle be extracted from the instantaneous projected velocity field; a metric representation, which requires the extraction of visual acceleration, is not required. The stimulus consisted of a slanted planeP (specified by three points) and two pointsQ ₁ andQ ₂ that are non-coplanar withP. This configuration of points oscillated rigidly around the vertical axis. We have measured thesystematic error andaccuracy with which human subjects estimate the relative distance of pointsQ ₁ andQ ₂ from planeP as a function of the slant of_P. The systematic error varies with slant: it is low for small slant values, reaches a maximum for medium slant values, and drops again for high slant values. The accuracy covaries with the systematic error and is thus high for small and large slant values and low for medium slant values. These results are successfully modeled by a simple relief-from-motion computation based on local estimates of projected velocities. The data are well predicted by assuming (1) a measurement error in velocity estimation that varies proportionally to velocity (Weber’s law) and (2) an eccentricity-dependent underestimation of velocity.     

A behavioral link between the oculomotor and cardiovascular systems

Although the eyes and the heart serve very different purposes, each receives autonomic innervation. Capitalizing on recent theoretical and technological innovations in the understanding and assessment of oculomotor and cardiovascular behavior, three experiments measured behavioral covariation between the oculomotor and cardiovascular systems. Measures of dark focus and dark vergence indexed oculomotor tone, and the spectral decomposition of variations in heart rate indexed cardiovascular control mechanisms. In Experiment 1, individual differences in cardiovascular parameters could predict individuals’ dark vergence (R²=.806) but not their dark focus (R²=.404). In Experiment 2, the same parameters were measured from subjects who experience either panic attacks (n=11) or blood phobia (n=9). Heart rate was positively correlated with dark vergence and the two subject groups were separable based on both oculomotor and cardiovascular variables. Using a within-subjects approach, Experiment 3 found that both dark vergence and dark focus tended to be nearer during sympathetic dominance of the heart than during parasympathetic dominance, within-subjects variations in cardiovascular parameters could predict dark focus, and between-subjects variations in interbeat intervals could predict dark vergence. Shared patterns of autonomic activation may be responsible for this eye-heart link.     

Consciousness: A neurobiological approach

Consciousness and the disorders of consciousness can be more fully understood once they are integrated with the neurobiology of mental events. After a review of animal and human research, we found several anatomical structures in the central nervous system are required for consciousness. Identification of the critical structures, however, depends on what is meant by consciousness. In the general sense of mental responsivity, the reticular activating system must be intact. Consciousness has also been defined as the awareness of the sights, sounds, and feelings of everyday experience. In this sense, the system of sensory inputs and outputs of the anterior temporal cortex, amygdala, and the hippocampus must be functional. There is no neural evidence for “higher” consciousness.     

The assessment of cortisol using salivary ultrafiltrate

Cortisol can be used to indicate stress level as well as to monitor certain disease states. Although cortisol can be sampled from blood and urine, saliva sampling has decided advantages. Unfortunately, whole saliva contains a number of substances that can metabolize or bind with cortisol, potentially confounding analysis and quantitation. We introduce a semipermeable pouch that accumulates a contaminant-free salivary ultrafiltrate, thereby overcoming a number of the problems encountered with whole saliva. In three studies, we demonstrate accuracy and utility of the device for cortisol determination: (1) in an artificial medium, 60%–77% of the cortisol was recovered in the ultrafiltrate; (2) in vivo, ultrafiltrate cortisol correlated highly with whole-saliva cortisol collected under ideal conditions; and (3) ultrafiltrate cortisol evinced positive relationships with depression and cigarette use, consistent with studies in the literature. We conclude that this device and saliva-filtering technologies in general are useful in applications requiring quantitation of cortisol.     

A pointing technique for rapidly collecting localization responses in auditory research

A technique is described for rapidly collecting responses in auditory-localization experiments. Subjects indicate the perceived direction of the sound by pointing at a 20-cm-diam spherical model. In Experiment 1, the subjects judged the direction of a broadband signal, which could originate from any of 239 directions ranging through 360° of azimuth and between ?45° and +90° of elevation. Using this technique, the subjects responded 2–8 times more rapidly than previous subjects who used either a verbal-reporting technique or a head-pointing technique. Localization judgments were as accurate as they had been with verbal reports, but were not as accurate as judgments collected using the head-pointing technique. In Experiment 2, the signal was turned off and the experimenter read the spherical coordinates of the signal location to the subjects. The subjects pointed to these coordinates more accurately than they had judged the direction of the sounds in Experiment 1, suggesting that the response technique had not been the limiting factor in that experiment. Circumstances relevant to the choice of response techniques for auditory-localization experiments are discussed.     

The mediating role of anxiety in self-reported somatic complaints of depressed adolescents

This study examined the mediating role of anxiety in the self-reports of somatic complaints in 96 depressed adolescent inpatients. Sixty-four subjects with major depressive episodes and comorbid anxiety disorders (MDE-A) determined from the Diagnostic Interview for Children and Adolescents-Revised (DICA-R) reported significantly more somatic complaints than 32 adolescents having major depressive episodes without comorbid anxiety (MDE). An analysis of covariance demonstrated that, with anxiety symptoms controlled, MDE and MDE-A groups did not differ significantly in somatic complaints. A hierarchical multiple-regression analysis revealed that, with demographic and anxiety symptoms controlled, depressive symptoms did not contribute to the explanation or prediction of somatic complaints. The results suggest that anxious, but not depressive symptoms, are independently associated with somatic complaints. The results are discussed in light of new affective models of psychopathology.