Applying evidence to support ethical decisions: Is the placebo really powerless?

Using placebos in day-to-day practice is an ethical problem. This paper summarises the available epidemiological evidence to support this difficult decision. Based on these data we propose to differentiate between placebo and “knowledge framing”. While the use of placebo should be confined to experimental settings in clinical trials, knowledge framing — which is only conceptually different from placebo — is a desired, expected and necessary component of any doctor-patient encounter. Examples from daily practice demonstrate both, the need to investigate the effects of knowledge framing and its impact on ethical, medical, economical and legal decisions. An earlier version of this paper was presented at an international conference, “Placebo: Its Action and Place in Health Research Today,” held in Warsaw, Poland on 12–13 April, 2003.     

Speech production mechanisms in aphasia: A delayed auditory feedback study

Data collected from a delayed auditory feedback (DAF) study conducted by F. Boller, P. B. Vrtunski, Y. Kim, and J. L. Mack (1978, Cortex, 14, 212–226) were reanalyzed to determine if speech quality measures which were significantly affected during DAF could be operationalized and to ascertain which type of errors are responsible for the judgement. A second goal of this study was to determine if Conduction aphasics were relatively spared under conditions of DAF, as has been shown in previous studies. Twenty aphasic patients and ten controls were presented with several speech production tasks under two delay conditions and two simultaneous feedback conditions. Results indicated that only the category of vowel length produced a significant number of errors, suggesting that DAF affects articulatory implementation. Conduction aphasics showed the least effect of all the groups. These results support Wernicke's and Geschwind's model, in which Conduction aphasics have a disconnection between the sensory and motor images of words. In contrast, Broca's aphasics were the most affected group under DAF, suggesting that a major component of their disorder is phonetic in nature.     

Recognizing faces across continents: The effect of within-race variations on the own-race bias in face recognition

People are better at recognizing faces of their own race than faces of other racial groups. This own-race bias (ORB) in face recognition manifests in some studies as a full crossover interaction between race of observer and race of face, but in others the interaction is accompanied by main effects or other complexities. We hypothesized that this may be due in part to unacknowledged within-race variation and the implicit assumption that the terms white and black describe perceptually homogeneous race categories. We therefore tested white and black South Africans on their recognition of black and white American faces and black and white South African faces. Our results showed the expected interaction, but only for South African faces. This finding supports explanations of the ORB that are premised on intergroup contact and perceptual experience and highlights the danger of assuming homogeneity of appearance within groups. Author Note     

The Relevance of Social Theory in the Practice of Environmental Management

In this paper I argue that the dominance of certain paradigms and theories on policies can have an influence on the value added by impact assessments. A link exists between paradigms and theories and policies and consequently the practices humans develop to tackle real world problems. I also argue that different types of thinking (contained in paradigms and theories) need to be integrated, at least at the scientific level, to enhance our understanding of social phenomena. This in turn can have a positive influence on policy processes that follow impact assessment recommendations. I am not arguing for the adoption of theoretical positions by practitioners, Instead, I contend that if impact assessments are informed by a variety of paradigms and theories, the policy practitioner might have a better understanding of the issue and the moral choices he or she needs to make. I will highlight the connection between theory and policies with practical examples from the social impact assessment of the De Hoop Dam, which was constructed on the Steelpoort River. I also argue for an integration of different theories to give a deeper understanding of real world problems.     

Psychic reality in the psychoanalytic process.

The case is made for regarding psychic reality as synonymous with subjective (conscious) experience, which is inherently open to, but not reducible to, unconscious determinants. Both analyst and analysand engage in the analytic relation and interaction from the perspective of their respective psychic realities. Thus, components of the analytic relation--transference/countertransference, alliance, and real relation--are forms of psychic reality. The tensions of subjectivity and objectivity are discussed in relation to the analytic situation, especially with regard to whether the patient's or the analyst's psychic reality is to be given priority or preference. The same reality, situation, or relationship can be viewed from different perspectives and subjected to varying interpretations without any one being exclusively true or false-each may be partially true and/or partially false. The patient's recounting of his history is a part of the patient's psychic reality that intersects with a necessarily divergent account constructed by the analyst. The ensuing dialogue seeks a form of real coherence that is mutually realistic and makes realistic sense for both parties. Reliance on subjective psychic reality becomes a possible, but precarious and potentially misleading, basis for analytic understanding without other observational (verbal and behavioral) or objective data.     

Visually controlled space orientation in endogenous psychoses

The visual controlled behaviour in space is measured in 30 psychotic patients. In a room with a row of 8 equal chairs we measured the right-left-choice and the choice of distance. The neglect of the left chairs in patient with "distrust" and "delusion" let us suppose a right hemispherical dysfunction. There is no correlation between psychosis and choice of distance, but a good correlation between disturbed parental home and near distance.