The Medical Humanities and the Perils of Curricular Integration

The advent of integration as a feature of contemporary medical curricula can be seen as an advantage for the medical humanities in that it provides a clear implementation strategy for the inclusion of medical humanities content and/or perspectives, while also making its relevance to medical education more apparent. This paper discusses an example of integration of humanities content into a graduate medical course, raises questions about the desirability of an exclusively integrated approach, and argues for the value of retaining a discrete and coherent disciplinary presence for the medical humanities in medical curricula.     

Speeded verbal responding in adults who stutter: are there deficits in linguistic encoding?

Linguistic encoding deficits in people who stutter (PWS, n=18) were investigated using auditory priming during picture naming and word vs. non-word comparisons during choice and simple verbal reaction time (RT) tasks. During picture naming, PWS did not differ significantly from normally fluent speakers (n=18) in the magnitude of inhibition of RT from semantically related primes and the magnitude of facilitation from phonologically related primes. PWS also did not differ from controls in the degree to which words were faster than non-words during choice RT, although PWS were slower overall than controls. Simple RT showed no difference between groups, or between words and non-words, suggesting differences in speech initiation time do not explain the choice RT results. The findings are consistent with PWS not being deficient in the time course of lexical activation and selection, phonological encoding, and phonetic encoding. Potential deficits underlying slow choice RTs outside of linguistic encoding are discussed. EDUCATIONAL OBJECTIVES: The reader will be able to (1) describe possible relationships between linguistic encoding processes and speech motor control difficulties in people who stutter; (2) explain the role of lexical priming tasks during speech production in evaluating the efficiency of linguistic encoding; (3) describe the different levels of processing that may be involved in slow verbal responding by people who stutter, and identify which levels could be involved based on the findings of the present study.     

The effects of late acquisition of L2 and the consequences of immigration on L1 for semantic and morpho-syntactic language aspects

It has been hypothesized that some aspects of a second language (L2) might be learned easier than others if a language is learned late. On the other hand, non-use might result in a loss of language skills in one's native, i.e. one's first language (L1) (language attrition). To study which, if any, aspects of language are affected by either late acquisition or non-use, long-term German immigrants to the US and English native speakers who are long-term immigrants to Germany as well as two additional control groups of native German speakers were tested with an auditory semantic and morpho-syntactic priming paradigm. German adjectives correctly or incorrectly inflected for gender and semantically associated or not associated with the target noun served as primes. Participants made a lexical decision on the target word. All groups of native German speakers gained from semantically and morpho-syntactically congruent primes. Evidence for language attrition was neither found for semantic nor morpho-syntactic priming effects in the German immigrants. In contrast, English native speakers did not gain from a morpho-syntactic congruent prime, whereas semantic priming effects were similar as for the remaining groups. The present data suggest that the full acquisition of at least some syntactic functions may be restricted to limited periods in life while semantic and morpho-syntactic functions seem to be relatively inured to loss due to non-use.     

Individual differences in neural mechanisms of selective auditory attention in preschoolers from lower socioeconomic status backgrounds: an event‐related potentials study

Selective attention, the ability to enhance the processing of particular input while suppressing the information from other concurrent sources, has been postulated to be a foundational skill for learning and academic achievement. The neural mechanisms of this foundational ability are both vulnerable and enhanceable in children from lower socioeconomic status (SES) families. In the current study, we assessed individual differences in neural mechanisms of this malleable brain function in children from lower SES families. Specifically, we investigated the extent to which individual differences in neural mechanisms of selective auditory attention accounted for variability in nonverbal cognitive abilities in lower SES preschoolers. We recorded event‐related potentials (ERPs) during a dichotic listening task and administered nonverbal IQ tasks to 124 lower SES children (77 females) between the ages of 40 and 67 months. The attention effect, i.e., the difference in ERP mean amplitudes elicited by identical probes embedded in stories when attended versus unattended, was significantly correlated with nonverbal IQ scores. Larger, more positive attention effects over the anterior and central electrode locations were associated with superior nonverbal IQ performance. Our findings provide initial evidence for prominent individual differences in neural indices of selective attention in lower SES children. Furthermore, our results indicate a noteworthy relationship between neural mechanisms of selective attention and nonverbal IQ performance in lower SES preschoolers. These findings provide the basis for future research to identify the factors that contribute to such individual differences in neural mechanisms of selective attention.     

Capturing Dynamic Processes of Change in GROW Mutual Help Groups for Mental Health

The need for a model that can portray dynamic processes of change in mutual help groups for mental health (MHGMHs) is emphasized. A dynamic process model has the potential to capture a more comprehensive understanding of how MHGMHs may assist their members. An investigation into GROW, a mutual help organization for mental health, employed ethnographic, phenomenological and collaborative research methods. The study examined how GROW impacts on psychological well being. Study outcomes aligned with the social ecological paradigm (Maton in Understanding the self-help organization: frameworks and findings. Sage, Thousand Oaks 1994) indicating multifactorial processes of change at and across three levels of analysis: group level, GROW program/community level and individual level. Outcome themes related to life skills acquisition and a change in self-perception in terms of belonging within community and an increased sense of personal value. The GROW findings are used to assist development of a dynamic multi-dimensional process model to explain how MHGMHs may promote positive change.     

The Relationship Between Racial Identity Cluster Profiles and Psychological Distress Among African American College Students

One hundred eighty‐two African American college students completed the Racial Identity Attitudes Scale. Results from the multivariate categorization scheme revealed 5 types of empirically derived racial identity attitude profiles: “dissonance internalization” (34%), “committed internalization” (30%), “cngaged internalization” (21%), “undifferentiated racial identity” (8%), and “dormant racial identity” (7%). The profiles significantly differed on Brief Symptom Inventory subscale scores.     

Cognitive-Behavioural Treatment of School-Refusing Children: Maintenance of improvement at 3- to 5-year follow-up

Although evidence is accumulating on the immediate or short-term efficacy of cognitive-behavioural strategies in the treatment of school refusal, no studies have been reported on the long-term efficacy of this treatment approach. An earlier randomized clinical trial conducted by the authors demonstrated the efficacy of a manual-based cognitive-behavioural treatment program for school refusal relative to waiting list controls. We now report findings of a 3- to 5-year follow-up investigation of the treatment group. In general, results support the long-term efficacy of the treatment program, with children showing maintenance of improvements in school attendance and school adjustment. Methodological limitations of the follow-up investigation are emphasized.