Propositional Versus Structural Semantic Analyses of Medical Diagnostic Thinking

Two approaches to the study of diagnostic thinking are compared, one mainly propositional, namely that of Patel and Groen (1986), the other mainly semantic, that of Lemieux and Bordage (1986). Patel and Groen analyzed the linear dimension of cardiologists' discourses while solving a case of acute bacterial endocarditis, that is, the before and after propositional rules. A secondary analysis of two of their pothophysiological protocols is done using structural semantic techniques from Lemieux and Bordage where the vertical dimension of the discourses is analyzed, that is, the levels of meaning or semantic axes. Contrary to Patel and Groen's position, making an accurate diagnosis is not explained in terms of pure forward reasoning through networks of causal rules, but by means of networks of semantic qualities abstracted from the symptoms and signs. The semantic qualities operate in the clinician's mind in terms of binary oppositions (e.g., sudden-gradual, unilateral-bilateral) whereby each pair of properties constitutes a semantic axis (e.g., sudden-gradual). The successful diagnosticians are those who use the most diversified and pertinent set of semantic axes and, therefore, have a deeper representation of the problem.     

The Moral Problem of Risk Impositions: A Survey of the Literature

This paper surveys the current philosophical discussion of the ethics of risk imposition, placing it in the context of relevant work in psychology, economics and social theory. The central philosophical problem starts from the observation that it is not practically possible to assign people individual rights not to be exposed to risk, as virtually all activity imposes some risk on others. This is the ‘problem of paralysis’. However, the obvious alternative theory that exposure to risk is justified when its total benefits exceed its total costs faces the standard distributional challenges of consequentialism. Forms of contractualism have been proposed as a solution, but how exactly such theories can be formulated remains problematic, especially when confronted with the difficult cases of mass, novel, risk such as climate change.     

The Cambridge Car Memory Test: A task matched in format to the Cambridge Face Memory Test, with norms, reliability, sex differences, dissociations from face memory, and expertise effects

Many research questions require a within-class object recognition task matched for general cognitive requirements with a face recognition task. If the object task also has high internal reliability, it can improve accuracy and power in group analyses (e.g., mean inversion effects for faces vs. objects), individual-difference studies (e.g., correlations between certain perceptual abilities and face/object recognition), and case studies in neuropsychology (e.g., whether a prosopagnosic shows a face-specific or object-general deficit). Here, we present such a task. Our Cambridge Car Memory Test (CCMT) was matched in format to the established Cambridge Face Memory Test, requiring recognition of exemplars across view and lighting change. We tested 153 young adults (93 female). Results showed high reliability (Cronbach's alpha = .84) and a range of scores suitable both for normal-range individual-difference studies and, potentially, for diagnosis of impairment. The mean for males was much higher than the mean for females. We demonstrate independence between face memory and car memory (dissociation based on sex, plus a modest correlation between the two), including where participants have high relative expertise with cars. We also show that expertise with real car makes and models of the era used in the test significantly predicts CCMT performance. Surprisingly, however, regression analyses imply that there is an effect of sex per se on the CCMT that is not attributable to a stereotypical male advantage in car expertise.     

BodiMojo: Effective Internet-based promotion of positive body image in adolescent girls

This study tested the efficacy of an Internet-based health promotion program, BodiMojo, designed to promote positive body image in adolescents. Participants were 178 students (mean age 15.2 years, 67.6% ethnic minority) in three public high schools. Intervention groups used BodiMojo for four weekly health class periods, while controls participated in their usual health curriculum. Body image measures were given at baseline, post-intervention, and 3 months. Girls reported decreased body dissatisfaction (p < .05), decreased physical appearance comparison (p < .05), and increased appearance satisfaction (p < .05), relative to controls. Effects were not maintained at 3-month follow-up. No significant differences were found between the intervention and control groups with boys. Moderation analyses suggested positive effects for diverse adolescents as well as those who were overweight or indicated baseline high body dissatisfaction. BodiMojo appears to be modestly effective in decreasing body image concerns among adolescent girls in the short term.     

Children and Adolescents with Medically Unexplained Symptoms: A Systematic Review of the Literature

Abstract

Medically unexplained symptoms (MUS) in children and adolescents are confounding and concerning for patients, parents, and health care practitioners. Our goal was to review and summarize the literature for family therapists working with a diverse, challenging patient population coping with MUS. A search of multiple databases from 1994 to 2018 was conducted using MUS and related terms. The literature was then organized into subcategories based on its relevance to family therapists, particularly medical family therapists collaborating with primary care physicians. We conclude with a discussion about gaps in the literature and suggestions for clinical management.     

Parameterizing the attentional blink effect.

The attentional blink effect (AB) is used to examine the limits of attention in dual-task paradigms. However, since the effect is nonlinear, it is sometimes difficult to characterize the results. Furthermore, it is difficult to assess the significance of the effect between groups because the results are highly variable both within and across subjects. In this paper, we propose a method to quantify four characteristics of the AB curve: the minimum performance, the amplitude between the minimum and the asymptotic performance, the amount of Lag-1 sparing, and the width of the effect. The method, based on curve fitting, allows easier comparisons of the results across experiments, can test only one characteristic at a time, and yields more powerful statistical tests.