Ethical Design of Intelligent Assistive Technologies for Dementia: A Descriptive Review

The use of Intelligent Assistive Technology (IAT) in dementia care opens the prospects of reducing the global burden of dementia and enabling novel opportunities to improve the lives of dementia patients. However, with current adoption rates being reportedly low, the potential of IATs might remain under-expressed as long as the reasons for suboptimal adoption remain unaddressed. Among these, ethical and social considerations are critical. This article reviews the spectrum of IATs for dementia and investigates the prevalence of ethical considerations in the design of current IATs. Our screening shows that a significant portion of current IATs is designed in the absence of explicit ethical considerations. These results suggest that the lack of ethical consideration might be a codeterminant of current structural limitations in the translation of IATs from designing labs to bedside. Based on these data, we call for a coordinated effort to proactively incorporate ethical considerations early in the design and development of new products.     

The sound of enemies and friends in the neighborhood

Previous studies (e.g., Pecher, Zeelenberg, & Wagenmakers, 2005) found that semantic classification performance is better for target words with orthographic neighbors that are mostly from the same semantic class (e.g., living) compared to target words with orthographic neighbors that are mostly from the opposite semantic class (e.g., nonliving). In the present study we investigated the contribution of phonology to orthographic neighborhood effects by comparing effects of phonologically congruent orthographic neighbors (book-hook) to phonologically incongruent orthographic neighbors (sand-wand). The prior presentation of a semantically congruent word produced larger effects on subsequent animacy decisions when the previously presented word was a phonologically congruent neighbor than when it was a phonologically incongruent neighbor. In a second experiment, performance differences between target words with versus without semantically congruent orthographic neighbors were larger if the orthographic neighbors were also phonologically congruent. These results support models of visual word recognition that assume an important role for phonology in cascaded access to meaning.     

Spatial navigation in complex and radial mazes in APP23 animals and neurotrophin signaling as a biological marker of early impairment

Impairment of hippocampal function precedes frontal and parietal cortex impairment in human Alzheimer's disease (AD). Neurotrophins are critical for behavioral performance and neuronal survival in AD. We used complex and radial mazes to assess spatial orientation and learning in wild-type and B6-Tg(ThylAPP)23Sdz (APP23) animals, a transgenic mouse model of AD. We also assessed brain content of nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and neurotrophin-3 (NT-3). Performance was alike in wild-type and APP23 animals in the radial maze. In contrast, performance in the complex maze was better in wild-type than APP23 animals. Contrary to the wild-type, hippocampal BDNF levels decreased on training in APP23 animals. Hippocampal and frontal cortex NGF levels in APP23 animals correlated with the time to solve the complex maze, but correlated inversely with escape time in wild-type animals. NT-3 levels were alike in wild-type and APP23 animals and were unchanged even after training. Both types of mazes depend on hippocampal integrity to some extent. However, according to the cognitive mapping theory of spatial learning, the complex maze because of the increased complexity of the environment most likely depends more strongly on preserved hippocampal function than the radial maze in the working memory configuration applied here. Greater impairment in complex maze performance than in radial maze performance thus resembles the predominant affliction of the loss of hippocampal function in human AD. NGF and BDNF levels on maze learning are different in wild-type and transgenic animals, indicating that biological markers of AD may be altered on challenge even though equilibrium levels are alike.     

Technical intelligence in animals: the kea model

The ability to act on information flexibly is one of the cornerstones of intelligent behavior. As particularly informative example, tool-oriented behavior has been investigated to determine to which extent nonhuman animals understand means-end relations, object affordances, and have specific motor skills. Even planning with foresight, goal-directed problem solving and immediate causal inference have been a focus of research. However, these cognitive abilities may not be restricted to tool-using animals but may be found also in animals that show high levels of curiosity, object exploration and manipulation, and extractive foraging behavior. The kea, a New Zealand parrot, is a particularly good example. We here review findings from laboratory experiments and field observations of keas revealing surprising cognitive capacities in the physical domain. In an experiment with captive keas, the success rate of individuals that were allowed to observe a trained conspecific was significantly higher than that of naive control subjects due to their acquisition of some functional understanding of the task through observation. In a further experiment using the string-pulling task, a well-probed test for means-end comprehension, we found the keas finding an immediate solution that could not be improved upon in nine further trials. We interpreted their performance as insightful in the sense of being sensitive of the relevant functional properties of the task and thereby producing a new adaptive response without trial-and-error learning. Together, these findings contribute to the ongoing debate on the distribution of higher cognitive skills in the animal kingdom by showing high levels of sensorimotor intelligence in animals that do not use tools. In conclusion, we suggest that the 'Technical intelligence hypothesis' (Byrne, Machiavellian intelligence II: extensions and evaluations, pp 289-211, 1997), which has been proposed to explain the origin of the ape/monkey grade-shift in intelligence by a selection pressure upon an increased efficiency in foraging behavior, should be extended, that is, applied to some birds as well.     

When pestilence prevails...physician responsibilities in epidemics

The threat of bioterrorism, the emergence of the SARS epidemic, and a recent focus on professionalism among physicians, present a timely opportunity for a review of, and renewed commitment to, physician obligations to care for patients during epidemics. The professional obligation to care for contagious patients is part of a larger "duty to treat," which historically became accepted when 1) a risk of nosocomial infection was perceived, 2) an organized professional body existed to promote the duty, and 3) the public came to rely on the duty. Physicians' responses to epidemics from the Hippocratic era to the present suggests an evolving acceptance of the professional duty to treat contagious patients, reaching a long-held peak between 1847 and the 1950's. There has been some professional retrenchment against this duty to treat in the last 40 years but, we argue, conditions favoring acceptance of the duty are met today. A renewed embrace of physicians' duty to treat patients during epidemics, despite conditions of personal risk, might strengthen medicine's relationship with society, improve society's capacity to prepare for threats such as bioterrorism and new epidemics, and contribute to the development of a more robust and meaningful medical professionalism.     

When is the ball going to hit the ground? Duration estimates, eye movements, and mental imagery of object motion

Performance in 2 versions of a computer-animated task was compared. Participants either indicated the time of arrival of a target that rolled off a horizontal surface and fell--hidden from view--onto a landing point (production task) or judged flight time on a rating scale (judgment task). As predicted, performance was significantly better in the production task (Experiment 1), in which imagery of object motion probably replaced reasoning processes. Participants who exhibited eye movements suggesting mental tracking performed particularly well in the production task (Experiment 2). There was, however, no decrement in performance when participants were asked to fixate the point where the target disappeared. For motion duration estimations, eye movements seem to be only a by-product of mental tracking.     

Detectability of the negative event: effect on the acceptance of pre- or post-event risk-defusing actions

In risky decision situations, many decision makers search for risk-defusing operators (RDOs). An RDO is an action intended by the decision maker to be performed additionally to a specific alternative and is expected to decrease the risk. Pre-event RDOs (e.g., vaccination) have to be applied before a negative event (e.g., infection) occurs. Post-event RDOs do not need to be initiated before and unless the event happens (e.g., medical treatment). For the successful application of Post-event RDOs, the negative event must be detected in time. Two experiments investigated the effect of uncertainty in the detection of the negative event. In Experiment 1, only a small minority of subjects noted this uncertainty without a cue, and even with cue, only a minority actively searched for probability information. In Experiment 2, the probability for correctly detecting the negative event was varied. When detection was certain, most subjects chose the alternative with a Post-event RDO, whereas this percentage decreased significantly with decreasing probability of correct detection. Also, in the conditions with a more extreme negative outcome, less decision makers chose the alternative with the Post-event RDO.     

Parents of the Handicapped Child: Facilitating Acceptance Through Group Counseling

All parents have an image of the way they would like their children to be. Often this expectation is contradicted by reality for the parents of a handicapped child. Whether at the time of birth when obvious differences are apparent or later when performance differences are recognized, the discrepancy between expectation and reality causes parents to experience a loss and accompanying feelings of grief. This article suggests that the method of group counseling using a relevant framework on which to base discussion is without equal as a means of assisting parents to deal with their situations. Presented to those who lead parent groups for these persons is an applicable model and guidelines for its implementation.     

Natural categorization through multiple feature learning in pigeons

Recently (Troje, Huber, Loidolt, Aust, & Fieder 1999), we found that pigeons discriminated between large sets of photorealistic frontal images of human faces on the basis of sex. This ability was predominantly based on information contained in the visual texture of those images rather than in their configural properties. The pigeons could learn the distinction even when differences of shape and average intensity were completely removed. Here, we proved more specifically the pigeons' flexibility and efficiency to utilize the class-distinguishing information contained in complex natural classes. First, we used principal component as well as discriminant function analysis in order to determine which aspects of the male and female images could support successful categorization. We then conducted various tests involving systematic transformations and reduction of the feature content to examine whether or not the pigeons' categorization behaviour comes under the control of categorylevel feature dimensions-that is, those stimulus aspects that most accurately divide the stimulus classes into the experimenter-defined categories of 'Male' and 'Female'. Enhanced classification ability in the presence of impoverished test faces that varied only along one of the first three principal components provided evidence that the pigeons used these class-distinguishing stimulus aspects as a basis for generalization to new instances.     

Commentaries on “Beyond statistical significance: Five principles for the new era of data analysis and reporting”

Three commentaries below provide different perspectives on data analysis and reporting. They generally focus on how the quality of the measures and manipulations determines the value of the analysis. Norbert Schwarz and Fritz Strack's comment is less on the right statistic and more on “sloppy reasoning, gaps between theoretical concepts and their operationalizations, and blissful ignorance of the situated nature of human thinking, feeling, and doing contribute more to the limited reproducibility of empirical findings than the choice of a particular test statistic.” They propose that particular effects are contextual and inappropriately labeled as true or false. Instead, our job is to focus on general constructs that make sense of the diversity of human experience and psychological reactions. Too often studies replicating psychological effects in the noisy and confounded conditions of the marketplace result in statistical uncertainty of garbage in, garbage out. Researchers instead need to look toward tests of specific interactions, which can clarify the influencing factors based on theoretical considerations. The second comment is by Andrew Gelman, an outstanding psychological statistician. He proposes that “once the data have been collected, the most important decisions have already been done.” He then provides four recommendations that enable the statistics to work appropriately. The first requirement of an effective study is to be sure that the measures address the construct of interest. Similar to the position of Schwarz and Strack, it is important to articulate the relevance of a statistically significant finding. The second recommendation seeks to curb large number of studies with inflated effect sizes built from narrow studies and unwarranted optimism. The third recommendation is to simulate data from a model and consider the distribution of possible results. That is often done to test a new analysis method, but it can be even more important in marketplace studies where novel characteristics of the sample and experimental conditions are included in the analysis. Finally, he recommends that one consider likely analyses needed before getting the data. Such foresight would encourage, for example, thinking about the kind of data needed to defend the equality of the control demographics against the treatment. The final commentary is by Stijn van Osselaer. He agrees that p-values reflect the detailed methods from a given study but do not focus on the problem of generalizability. Like Gelman, he sees designs focused on effect sizes may have generated too many studies that do not replicate. He contrasts broad explorations with narrowly defined existence tests that provide evidence that an effect exists somewhere but are mute on other contexts where they may apply. For theoretical problems relevant to applications, it is important to identify moderators through broad sampling across population characteristics, stimuli, and situations. He proposes that consumer psychologists should not try to do everything in one paper, but to build practically relevant, applicable knowledge across multiple articles. Different articles, authors, and research methods play various roles, with each article focusing on important stages in the process from generating hypotheses, providing existence proofs, and exploring their broad applicability. That pragmatic approach can integrate theoretical silos that seek to resolve complex human problems and has promise as a criterion for relevant publications.