What is the Role of the Arts in Medical Education and Patient Care? A Survey-based Qualitative Study

To inform medical education reform efforts, we systematically collected information on the level of arts and humanities engagement in our medical school community. Attitudes regarding incorporating arts and humanities-based teaching methods into medical education and patient care were also assessed. An IRB-approved survey was electronically distributed to all faculty, residents, fellows, and students at our medical school. Questions focused on personal practice of the arts and/or humanities, as well as perceptions of, and experience with formally incorporating these into medical teaching. Of 13,512 community members surveyed, 2,775 responded (21% overall response rate). A majority of respondents agreed or strongly agreed that medical education and patient care could be "enhanced" by the integration of the arts (67% and 74% respectively). There was enthusiastic support for the creation of a formal program in the arts at our medical school (72 %). Integration of the arts into medical education may have a role in improving the quality of medical training and would likely be well received by teachers and learners.     

False recall in the Deese-Roediger-McDermott paradigm: The roles of gist and associative strength

Theories of false memories, particularly in the Deese-Roediger-McDermott (DRM) paradigm, focus on word association strength and gist. Backward associative strength (BAS) is a strong predictor of false recall in this paradigm. However, other than being defined as a measure of association between studied list words and falsely recalled nonpresented critical words, there is little understanding of this variable. In Experiment 1, we used a knowledge-type taxonomy to classify the semantic relations in DRM stimuli. These knowledge types predicted false-recall probability, as well as BAS itself, with the most important being situation features, synonyms, and taxonomic relations. In three subsequent experiments, we demonstrated that lists composed solely of situation features can elicit a gist and produce false memories, particularly when monitoring processes are made more difficult. Our results identify the semantic factors that underlie BAS and suggest how considering semantic relations leads to a better understanding of gist formation.     

The neurobiology of adaptive learning in reading: A contrast of different training conditions

fMRI was used to investigate the separate influences of orthographic, phonological, and semantic processing on the ability to learn new words and the cortical circuitry recruited to subsequently read those words. In a behavioral session, subjects acquired familiarity for three sets of pseudowords, attending to orthographic, phonological, or (learned) semantic features. Transfer effects were measured in an event-related fMRI session as the subjects named trained pseudowords, untrained pseudowords, and real words. Behaviorally, phonological and semantic training resulted in better learning than did orthographic training. Neurobiologically, orthographic training did not modulate activation in the main reading regions. Phonological and semantic training yielded equivalent behavioral facilitation but distinct functional activation patterns, suggesting that the learning resulting from these two training conditions was driven by different underlying processes. The findings indicate that the putative ventral visual word form area is sensitive to the phonological structure of words, with phonologically analytic processing contributing to the specialization of this region.     

The scaling of postural adjustments during bimanual load-lifting in traumatic brain-injured adults

Previous postural studies of traumatic brain injury (TBI) patients have been limited to identifying deficits in static and quasi-dynamic postural control tasks such as weight shifting. In this study, we examined whether or not patients with TBI are able to scale adequately their postural adjustments during the performance of the dynamic task of bimanual load-lifting. An age matched group of healthy adults served as controls. We used the Tetrax posturography system that calculates a stability score (ST) based on fluctuations in vertical ground reaction forces, normalized for body weight. During quiet standing, the ST scores of the TBI group were significantly higher than the control group. Forward weight shift and percentage change in the vertical ground reaction forces (lift postural adjustment (LPA) and post-lift postural adjustment (PLPA) scores) linearly increased with increasing load weight in both healthy and TBI subjects. Group differences were found in the magnitude of forward weight shift but not in the relative increase of the LPA and PLPA scores during the lifting and post-lifting phases respectively. The forward weight shift of the TBI group was lower-than-normal and asymmetrical--there was significantly less forward weight shift on the more affected than on the less affected limb. In addition, a significant amplitude coupling was found between the scaling of the weight shift of the heel and forefoot of each limb. However, no coupling was found between the weight shift amplitudes of homologous parts of both limbs in the TBI group. The results showed that scaling based on prior experience was preserved in the TBI group, though some TBI subjects demonstrated absent scaling in either the more affected or less affected heel or forefoot. The differences between the normal and TBI groups in postural adjustments are not necessarily a sign of pathology; rather they may represent a deliberate choice of the central nervous system to counteract predictable disturbances.     

Parental Meta-Emotion Philosophy in Families with Conduct-Problem Children: Links with Peer Relations

We addressed the question of whether mothers of conduct-problem (CP) children differ from mothers of non-CP children in their awareness and coaching of emotion, and also examined whether mother's awareness and coaching of emotion is associated with better peer relations in CP children. Meta-emotion philosophy, assessed through audio taped interviews, and preschool children's peer relations, observed in same-sex dyadic interaction with a close friend, were investigated in families with CP and non-CP children. Results indicated that mothers of CP children were less aware of their own emotions and less coaching of their children's emotions than mothers of non-CP children. Moderation analyses revealed that children's level of aggression moderated the relationship between mother's meta-emotion and children's peer play. For both aggressive and nonaggressive children, higher levels of mother awareness and coaching of emotion was associated with more positive and less negative peer play, although effects were stronger for families with nonaggressive children. These data suggest that both aggressive and nonaggressive children can benefit when parents are more aware and coaching of emotion. Implications for the development of an intervention program aimed at improving parental awareness and coaching of emotion is discussed.     

Abstract-concept learning and list-memory processing by capuchin and rhesus monkeys

Three capuchin monkeys (Cebus apella) touched the lower of 2 pictures (same) or a white rectangle (different), increased same/different abstract-concept learning (52% to 87%) with set-size increases (8 to 128 pictures), and were better than 3 rhesus monkeys (Macaca mulatta). Three other rhesus that touched the top picture before choices learned similar to capuchins but were better at list-memory learning. Both species' serial position functions were similar in shape and changes with retention delays. Other species showed qualitatively similar shape changes but quantitatively different time-course changes. In abstract-concept learning, qualitative similarity was shown by complete concept learning, whereas a quantitative difference would have been a set-size slope difference. Qualitative similarity is discussed in relation to general-process versus modular cognitive accounts.     

Semantic Influence on Processing Gender Agreement: Evidence from Hebrew

In the present study we examined the influence of manipulating the animacy of the sentential subject on the size of the syntactic priming effect induced by violation of subject–predicate gender agreement in Hebrew. The agreement violation delayed naming incongruent compared with congruent predicates. This priming effect was stronger when the sentential subject was an animate than an inanimate noun. Additional experiments revealed that: (1) the interaction between the priming effect and animacy of the subject could not be explained on the basis of differences in the phonological transparency of the gender inflection in the two groups of nouns, and (2) it was sensitive to the ratio of animate/inanimate conditions in a block. We suggest that the interaction between the processing of agreement and the effect of animacy is influenced by a controlled process of verifying the coherence of a currently identified word within a built-up context.     

Ambivalence Over Emotional Expression and Psychological Weil-Being Among Rheumatoid Arthritis Patients and Their Spouses1

Associations between ambivalence over emotional expression and psychological well-being among rheumatoid arthritis patients and their spouses were investigated. Sixty-nine couples completed questionnaires assessing ambivalence over emotional expression, emotional expressiveness, psychological well-being, and strategies used in coping with arthritis. Associations between the patient's ambivalence and psychological well-being were stronger for those married to a highly ambivalent spouse, although this pattern of results was not found for spouses. Lower psychological well-being among more ambivalent spouses, and to a lesser extent patients, could be partially explained by their greater use of passive and distancing coping strategies. Results emphasize the importance of taking a dyadic approach to the study of psychological functioning among chronically ill patients and their spouses.