What Can Feminist Epistemology Do for Surgery?

Surgery is an important part of contemporary health care, but currently much of surgery lacks a strong evidence base. Uptake of evidence‐based medicine (EBM) methods within surgical research and among practitioners has been slow compared with other areas of medicine. Although this is often viewed as arising from practical and cultural barriers, it also reflects a lack of epistemic fit between EBM research methods and surgical practice. In this paper we discuss some epistemic challenges in surgery relating to this lack of fit, and investigate how resources from feminist epistemology can help to characterize them. We point to ways in which these epistemic challenges may be addressed by gathering and disseminating evidence about what works in surgery using methods that are contextual, pluralistic, and sensitive to hierarchies.     

The development of cognitive empathy and concern in preschool children: A behavioral neuroscience investigation

This developmental neuroscience study examined the electrophysiological responses (EEG and ERPs) associated with perspective taking and empathic concern in preschool children, as well as their relation to parental empathy dispositions and children's own prosocial behavior. Consistent with a body of previous studies using stimuli depicting somatic pain in both children and adults, larger early (~200 ms) ERPs were identified when perceiving painful versus neutral stimuli. In the slow wave window (~800 ms), a significant interaction of empathy condition and stimulus type was driven by a greater difference between painful and neutral images in the empathic concern condition. Across early development, children exhibited enhanced N2 to pain when engaging in empathic concern. Greater pain‐elicited N2 responses in the cognitive empathy condition also related to parent dispositional empathy. Children's own prosocial behavior was predicted by several individual differences in neural function, including larger early LPP responses during cognitive empathy and greater differentiation in late LPP and slow wave responses to empathic concern versus affective perspective taking. Left frontal activation (greater alpha suppression) while engaging in affective perspective taking was also related to higher levels of parent cognitive empathy. Together, this multilevel analysis demonstrates the important distinction between facets of empathy in children; the value of examining neurobehavioral processes in development. It provides provoking links between children's neural functioning and parental dispositions in early development.     

Audio‐visual speech in noise perception in dyslexia

Individuals with developmental dyslexia (DD) may experience, besides reading problems, other speech‐related processing deficits. Here, we examined the influence of visual articulatory information (lip‐read speech) at various levels of background noise on auditory word recognition in children and adults with DD. We found that children with a documented history of DD have deficits in their ability to gain benefit from lip‐read information that disambiguates noise‐masked speech. We show with another group of adult individuals with DD that these deficits persist into adulthood. These deficits could not be attributed to impairments in unisensory auditory word recognition. Rather, the results indicate a specific deficit in audio‐visual speech processing and suggest that impaired multisensory integration might be an important aspect of DD.     

Does neighborhood size really cause the word length effect?

In short-term serial recall, it is well-known that short words are remembered better than long words. This word length effect has been the cornerstone of the working memory model and a benchmark effect that all models of immediate memory should account for. Currently, there is no consensus as to what determines the word length effect. Jalbert and colleagues (Jalbert, Neath, Bireta, & Surprenant, 2011a; Jalbert, Neath, & Surprenant, 2011b) suggested that neighborhood size is one causal factor. In six experiments we systematically examined their suggestion. In Experiment 1, with an immediate serial recall task, multiple word lengths, and a large pool of words controlled for neighborhood size, the typical word length effect was present. In Experiments 2 and 3, with an order reconstruction task and words with either many or few neighbors, we observed the typical word length effect. In Experiment 4 we tested the hypothesis that the previous abolition of the word length effect when neighborhood size was controlled was due to a confounded factor: frequency of orthographic structure. As predicted, we reversed the word length effect when using short words with less frequent orthographic structures than the long words, as was done in both of Jalbert et al.’s studies. In Experiments 5 and 6, we again observed the typical word length effect, even if we controlled for neighborhood size and frequency of orthographic structure. Overall, the results were not consistent with the predictions of Jalbert et al. and clearly showed a large and reliable word length effect after controlling for neighborhood size.     

The impact of implicitly and explicitly primed ingroup–outgroup categorization on the evaluation of others pain: The case of the Jewish–Arab conflict

Despite the automaticity of affective sharing, many studies have documented the role of top-down effects, such as social categorization, on people’s empathic responses. An important question, largely ignored in previous research, concerns empathy to ingroup and outgroup members’ pain in the contexts of ongoing intergroup conflict. In the present study we examined how implicit and explicit ethnic social categorization of others affects empathy to pain in the context of the Israeli–Palestinian conflict. To meet this aim, we assessed the evaluation of pain by Jewish and Arab participants who viewed a series of visual stimuli depicting painful and non-painful familiar situations. The stimuli were associated with explicitly or implicitly primed typical names depicting ingroup, neutral outgroup, and adversary outgroup members. Results demonstrate that pain ratings in the explicit priming condition provide support for the ingroup empathy hypothesis, positing that empathy is higher for ingroup than for outgroup members for both Jews and Palestinian Arabs. Conversely, when the targets’ categories are primed implicitly, results revealed difference in empathy by the two ethnic groups where an ingroup bias was detected only for Palestinian Arabs. This suggests that the activation of ingroup bias on the subliminal implicit level among Palestinian Arab participants might be mediated by the amount of conflict permeating in their daily lives and by deeply rooted cultural values and behavioural patterns.     

Reducing uncertainty to promote appropriate decisions when facing hazardous phenomena at an active volcano

This study investigated a new direction for improving the decision making of populations at risk in the context of uncertain environmental events, such as volcanic hazards. According to the risk as feelings theory and dual process models, situations with certain outcomes do not necessarily require the use of affect heuristics (e.g., experienced feelings, anticipated emotions) as valid information in the decision‐making process. In the case of difficult decisions with moral dilemmas, certainty could even improve decisions. Thus, using an ecological design with various scenarios depicting upcoming volcanic hazards, we examined whether reducing the uncertainty of lethal threat by conveying certainty in an information campaign could influence decision making and promote a better quality of choice (correct application of the recommendations from the competent authorities). We focused specifically on two populations composed of local people living in the vicinity of an active volcano (Tungurahua volcano, Ecuador) and local scientists. We also examined whether a difficult decision involving a moral dilemma (e.g., leaving people behind so as not to jeopardize one's own life) potentiated this effect, compared to a less difficult situation without a dilemma. We demonstrated that, for local people facing a moral dilemma (difficult decision), the reduction of uncertainty of lethal threat involved a better application of the actual recommendations. These outcomes provided perspectives on improving the applications of the recommendations among local populations at risk in the context of a real risk exposure.     

Feuerbach's theory of object‐relations and its legacy in 20th century post‐Hegelian philosophy

This paper focuses on the way in which Feuerbach's attempt to develop a naturalistic, realist remodeling of Hegel's relational ontology, which culminated in his own version of “sensualism”, led him to emphasize the vulnerability of the subject and the role of affectivity, thus making object‐dependence a constitutive feature of subjectivity. We find in Feuerbach the first lineaments of a philosophical theory of object‐relations, one that anticipates the well‐known psychological theory of the same name, but one that also offers a broader metaphysical basis in which all types of “essential objects” are shown to matter to subjectivity. This Feuerbachian theory of object‐relations, the paper then argues, foreshadows a number of important developments in 20th century post‐Hegelian philosophy. In it can be found an anticipation of Adorno's later theory of mimesis. Equally, this theory already emphasizes the “libidinal” nature of intentionality, in a way that announces Merleau‐Ponty's ontology of the flesh. Finally, the last section of the article proposes a model with which we might reconstruct the way in which object‐relations and self‐relations can be brought together consistently. In this instance, Feuerbach uses concepts that announce Freud's notion of “primary narcissism”. One contemporary philosopher who has proposed a sophisticated model of subjectivity, in which primary narcissism is shown to complement object‐dependence, is Axel Honneth. The last section argues that Feuerbach's full image of subjective identity as reciprocal scaffolding of self‐ and object‐relations reminds strongly of Honneth's core concept of “positive self‐relation”.     

Community Gender Norms Change as a Part of a Multilevel Approach to Sexual Health Among Married Women in Mumbai,India

Inequitable gender norms in societies and communities negatively contribute to women’s sexual and reproductive health. While the need for change in gender norms is well recognized, the task is highly challenging in terms of intervention design, implementation and assessment of impact. This paper describes a methodology for identification of gender norms, the design of community level intervention, community participation and the assessment of intervention impact in a low income, predominately Muslim community of 600,000 people in Mumbai, India. Formative research focused on in‐depth interviews with women, men and couples yielding gender normative statements and assessment of community resources to facilitate change. A Gender Equity Scale (GES) based on this formative research was developed and administered annually for a three‐year period to random, cross‐sectional samples in the intervention and control communities, and to community based, non‐governmental organizations (NGO) staff and Imams (religious leaders) in the intervention community. NGO staff disseminated gender oriented messages to their female constituency through their regular outreach activities and through special events and festivals in the community. Imams disseminated gender messages through lectures on social issues for men attending Friday prayers. The results showed that the NGO staff and Imams, assumed more gender equitable attitudes across time. The intervention was associated with a significant improvement in attitudes towards gender equity in the intervention relative to the control community. Men showed a dramatic change in more positive gender attitudes, while women lagged behind in their GES scores. The meaning of these results are explored and the implications assessed for the generalizability of the methodology for other countries, cultures and communities.     

School Counselors and Gifted Kids: Respecting Both Cognitive and Affective

Giftedness can be both an asset and a burden when gifted students respond to developmental challenges. Characteristics associated with high intellectual ability likely affect how gifted students experience social, emotional, and career development, regardless of level of academic achievement. Counselors' lack of awareness of such qualitative differences, as well as positive and negative biases, may interfere with the therapeutic relationship. Characteristics related to giftedness, vulnerabilities, concerns, and counseling strategies are the focus of this article.