Desires in Palliative Medicine. Five Models of the Physician‐Patient Interaction on Palliative Treatment Related to Hellenistic Therapies of Desire

In this paper, we explore the desires that play a role at the palliative stage and relate them to various approaches to patient autonomy. What attitude can physicians and other caregivers take to the desires of patients at the palliative stage? We examine this question by introducing five physicians who are consulted by Jackie, an imaginary patient with metastatic lung carcinoma. By combining the models of the physician-patient relationship developed by Emanuel and Emanuel (1992) and the Hellenistic approaches to desires analyzed by Nussbaum (1994), five different ways of dealing with desires in the context of palliative care are sketched. The story of Jackie shows that desires are to a certain extent responsive to reasoning. In the palliative process, that can be a reason to devote attention to the desires of patients and caregivers and to determine which desires need to be fulfilled, which are less important, and how they are linked to emotions the patient has.     

Detection of linear temporal drift in sound sequences: empirical data and modelling principles

Three experiments determined the perceptual threshold (JND) for detecting tempo change; i.e. linear continuous increase or decrease in inter onset interval (IOI) in sequences with 2-9 brief sounds. JND decreased as a power function of the number of intervals presented (Expt. 1). JND increased with IOI and exhibited breakpoints in this respect close to 1 and 1.4 s (Expt. 3), in agreement with previous results for serial interval production. No interaction was apparent between IOI and number of intervals (Expt. 2). None of the experiments showed any effect of direction (increasing or decreasing intervals). The results are inconsistent with several conceivable principles for perceiving tempo change, except for one in which the external intervals are compared with the intervals generated by an internal, periodic process. The plausibility of this principle is discussed in the light of recent research on sensorimotor synchronisation.     

Symmetry, averageness, and feature size in the facial attractiveness of women

Female facial attractiveness was investigated by comparing the ratings made by male judges with the metric characteristics of female faces. Three kinds of facial characteristics were considered: facial symmetry, averageness, and size of individual features. The results suggested that female face attractiveness is greater when the face is symmetrical, is close to the average, and has certain features (e.g., large eyes, prominent cheekbones, thick lips, thin eyebrows, and a small nose and chin). Nevertheless, the detrimental effect of asymmetry appears to result solely from the fact that an asymmetrical face is a face that deviates from the norm. In addition, a factor analysis indicated that averageness best accounts for female attractiveness, but certain specific features can also be enhancing.     

The group as a self-active system: Outline of a theory of group action

Human social systems, and groups in partlcular, are conceived as units which, as a whole, actively strive towards the achievement of external and internal goals. This ‘group action’ consists of simultaneous integrated processes on various individual and social levels. Our theory comprises four groups of constructs, which refer to task structure, group structure, information processing and execution. In an ongoing group action, the task structure is projected on the group structure; according to the resulting pattern, the group processes its action related information and executes the act. The latter two processes proceed on two levels, on an individual and on a group level. There are cognition, emotion and volition on the individual, and communication on the group level of information processing; execution proceeds in individual action and in cooperation. A specific part of the theory concerns analogies between individual cognition and intragroup communication.     

Different defense mechanisms among men with different sex role orientations

Thirty male college students completed the Bem Sex Role Inventory and the Defense Mechanism Inventory. Results demonstrated that sex role orientation moderates the use of defense mechanisms in men, so that men with different orientations differed in the defenses they used. Masculine men used externalizing defenses such as turning against object and rationalizing defenses such as principalization more often than feminine men. Feminine men used an internalizing mode of defense, such as turning against self, more often than masculine and androgynous men. Results were compared with similar studies and the implications were discussed.The order of the authors was alphabetically determined. The authors wish to thank Michal T. Lewy and Jacqueline Franko for their help in conducting the study.     

Type A behaviour pattern and assertive behaviour

The assertiveness patterns of Type A coronary-prone subjects were compared with those of Type B subjects in negative and positive situations. Type As were found to exhibit high assertiveness in both negative and positive situations. Type Bs responded as assertively as Type As in positive situations but less assertively in negative situations. The implications of the results are discussed.     

Reading Wittgenstein

Books reviewed in this essay:
Robert Arrington and Hans-Johann Glock (eds), Wittgenstein & Quine
John Koethe, The Continuity of Wittgenstein's Thought
P.M.S. Hacker, Wittgenstein's Place in Twentieth-Century Analytic Philosophy
Hans Sluga and David G. Stern (eds), The Cambridge Companion to Wittgenstein
Marie McGinn, Wittgenstein and the Philosophical Investigations     

Short versus long term gains of a cognitive-behavioral social skills program targeting the giving and receiving of criticism

Seventy-four university undergraduates (40.2% male and 59.8% female) reporting difficulty in giving and receiving criticism were randomly assigned to either a training group consisting of cognitive behavioral criticism skills including behavior rehearsal, modeling, coaching, cognitive restructuring, or to a control group. Dependent measures were given at pre-test, post-test, and one year follow-up. Included were self-report measures consisting of Fear of Negative Evaluation (FNE), Criticism Concerns Scale (CCS), Criticism Self-Esteem Giving and Receiving Scales, and behavioral role-play measures consisting of judges’ global ratings of subject’s verbal and nonverbal criticism behaviors in role-play scenarios with a live actor. Results for the self-report measures, FNE, and Criticism Self-Esteem Receiving showed both training program and control groups improved at post-test, but only the training program group maintained gains at one year follow-up. For the CCS and Criticism Self-Esteem Giving, the training program group improved over time, yet was only significantly different from control group at post-test. Results were discussed in terms of the pro-active nature of giving criticism versus the more reactive nature of receiving criticism.     

The effects of computer-mediated vocational guidance procedures on the appropriateness of vocational preference

To assess the effectiveness of vocational guidance procedures proposed for inclusion in a computer-based vocational exploration system, 139 eleventh-grade male subjects were randomly assigned to three experimental groups and a control group. One group was given a computer-generated accuracy of self-knowledge feedback, another group was taught an occupational classification scheme, a third group experienced both. Utilizing a method of explicit comparison between students' measured characteristics and the measured characteristics of occupational norm groups, the results showed students in the groups receiving feedback increased in the appropriateness of the occupational level of their first occupational choice. In addition, students in the combined treatment group increased in the appropriateness of the level of their total occupational preferences. A delayed posttest indicated that these increases persisted.     

Enhanced Hippocampal CA1 LTP but Normal Spatial Learning in Inositol 1,4,5-trisphosphate 3-kinase(A)-Deficient Mice

To define the physiological role of IP₃3-kinase(A) in vivo, we have generated a mouse strain with a null mutation of the IP₃3-kinase(A) locus by gene targeting. Homozygous mutant mice were fully viable, fertile, apparently normal, and did not show any morphological anomaly in brain sections. In the mutant brain, the IP₄ level was significantly decreased whereas the IP₃ level did not change, demonstrating a major role of IP₃3-kinase(A) in the generation of IP₄. Nevertheless, no significant difference was detected in the hippocampal neuronal cells of the wild-type and the mutant mice in the kinetics of Ca²⁺ regulation after glutamate stimulation. Electrophysiological analyses carried out in hippocampal slices showed that the mutation significantly enhanced the LTP in the hippocampal CA1 region, but had no effect on the LTP in dentate gyrus (DG). No difference was noted, however, between the mutant and the wild-type mice in the Morris water maze task. Our results indicate that IP₃3-kinase(A) may play an important role in the regulation of LTP in hippocampal CA1 region through the generation of IP₄, but the enhanced LTP in the hippocampal CA1 does not affect spatial learning and memory.