Cerebral Anesthetization for Localization of Speech: The Contribution of W. James Gardner

In 1949, the neurologist Juhn Wada reported the first use of a new procedure for determining the localization of speech and language in neurological patients: examination of the effects on speech and language after injecting a barbiturate, sodium amytal, into the internal carotid artery of each hemisphere in succession. By the 1960s, Wada'sIntracarotid Amobarbital Procedure,orIAP,had become the method of choice for identifying the speech-dominant side in one kind of neurological patient, persons with epilepsy who are candidates for surgical resection, and it remains so today. In 1941, however, an American neurosurgeon, W. James Gardner, reported his use of a different anesthetization procedure for speech localization in neurological patients. Instead of injecting sodium amytal through the blood supply, as in the IAP, Gardner injected procaine hydrochloride directly into cortical tissue. In this paper, we provide a brief biography of Gardner. We then discuss his method of cortical anesthetization, the theoretical and empirical background guiding his use of this method and his choice of patients, and, finally, the fate of Gardner's method within the scientific community.     

The influence of individuals on situations: Implications for understanding the links between personality and social behavior

In an analysis of the nature and origins of predictability in social behavior, two propositions are considered: (1) There exist categories of individuals whose social behavior is readily predictable from measures of personal attributes such as attitudes, traits, and dispositions as well as categories of individuals whose social behavior is readily predictable from situational and interpersonal specifications of behavioral appropriateness; (2) underlying these differences in predictability are systematic choices to enter and to spend time in social settings and interpersonal contexts that promote and facilitate one or other of these characteristic behavioral orientations. The implications of these propositions for the study of personality and social behavior are considered in the specific case of the psychological construct of self-monitoring and in the general case of understanding the reciprocal influences of individuals and their social worlds.     

Direct Comparison of Episodic Encoding and Retrieval of Words: An Event-related fMRI Study

Functional magnetic resonance imaging (fMRI) was used to compare directly episodic encoding and retrieval. During encoding, subjects studied visually presented words and reported via keypress whether each word represented a pleasant or unpleasant concept (intentional, deep encoding). During the retrieval phase, subjects indicated (via keypress) whether visually presented words had previously been studied. No reliable differences were found during the recognition phase for words that had been previously studied and those that had not been studied. Areas preferentially active during encoding (relative to retrieval) included left superior frontal cortex, medial frontal cortex, left superior temporal cortex, posterior cingulate, left parahippocampal gyrus, and left inferior frontal gyrus. Regions more active in retrieval than encoding included bilateral inferior parietal cortex, bilateral precuneus, right frontal polar cortex, right dorsolateral prefrontal cortex, and right inferior frontal/insular cortex.     

Surprise-induced blindness: a stimulus-driven attentional limit to conscious perception

The cost of attending to a visual event can be the failure to consciously detect other events. This processing limitation is well illustrated by the attentional blink paradigm, in which searching for and attending to a target presented in a rapid serial visual presentation stream of distractors can impair one's ability to detect a second target presented soon thereafter. The attentional blink critically depends on 'top-down' attentional settings, for it does not occur if participants are asked to ignore the first target. Here we show that 'bottom-up' attention can also lead to a profound but ephemeral deficit in conscious perception: Presentation of a novel, unexpected, and task-irrelevant stimulus virtually abolishes conscious detection of a target presented within half a second after the 'Surprise' stimulus, but only for its earliest occurrences (generally 1 to 2 presentations). This powerful but short-lived deficit contrasts with a milder but more enduring form of attentional capture that accompanies singleton presentations in rapid serial visual presentations. We conclude that the capture of stimulus-driven attention alone can limit explicit perception.     

Promoting social responsibility amongst health care users: medical tourists’ perspectives on an information sheet regarding ethical concerns in medical tourism

Background

Medical tourists, persons that travel across international borders with the intention to access non-emergency medical care, may not be adequately informed of safety and ethical concerns related to the practice of medical tourism. Researchers indicate that the sources of information frequently used by medical tourists during their decision-making process may be biased and/or lack comprehensive information regarding individual safety and treatment outcomes, as well as potential impacts of the medical tourism industry on third parties. This paper explores the feedback from former Canadian medical tourists regarding the use of an information sheet to address this knowledge gap and raise awareness of the safety and ethical concerns related to medical tourism.

Results

According to feedback provided in interviews with former Canadian medical tourists, the majority of participants responded positively to the information sheet and indicated that this document prompted them to engage in further consideration of these issues. Participants indicated some frustration after reading the information sheet regarding a lack of know-how in terms of learning more about the concerns discussed in the document and changing their decision-making. This frustration was due to participants’ desperation for medical care, a topic which participants frequently discussed regarding ethical concerns related to health care provision.

Conclusions

The overall perceptions of former medical tourists indicate that an information sheet may promote further consideration of ethical concerns of medical tourism. However, given that these interviews were performed with former medical tourists, it remains unknown whether such a document might impact upon the decision-making of prospective medical tourists. Furthermore, participants indicated a need for an additional tool such as a website for continued discussion about these concerns. As such, along with dissemination of the information sheet, future research implications should include the development of a website for ongoing discussion that could contribute to a raised awareness of these concerns and potentially increase social responsibility in the medical tourism industry.

     

The creativity quotient: An objective scoring of ideational fluency

A classical test for accessing the potential creativity of an individual is based on ideational fluency, where a person is asked to generate all possible uses for a familiar item like a piece of paper. In scoring the results, it is intuitive that the suggested uses should not be weighted equally. Those suggested in radically different categories are “worth more”; than those suggested within the same category only. We used information theory to derive a simple mathematical expression for a more objective measure of ideational fluency. We call this the creativity quotient (CQ). This innovative measure was examined using a small sample of participants, and is illustrated by the responses of two typical individuals from an ideational fluency task. The CQ accounts for the number of ideas (fluency), plus the number of categories (flexibility). Ongoing research will examine the independence of CQ from established measures of intelligence and personality.     

Workload Variability and Social Support: Effects on Stress and Performance

The current study investigated the effect of workload variability on performance and stress, as well as the role of social support as a potential intervention. Based on previous research it was predicted that a shift in workload from either high to low or low to high would lower performance and increase stress, while the provision of social support would result in higher performance and lower stress. Results revealed significant decrements in performance following workload shifts, though no increase in stress was perceived. Performance in both workload conditions significantly, but inconsistently, increased following the provision of social support and stress significantly decreased following the shift from high to low workload. Implications and future research steps are discussed further.     

The Visual Foucauldian: Institutional Coercion and Surveillance in Frederick Wiseman's Multi-handicapped Documentary Series

During the mid 1980s, the renowned American documentary filmmaker Fred Wiseman produced a four-part series of films that sought to record the operations of institutions in Talladega, Alabama, devoted to the care and training of people with disabilities. These films—designated as the Multi-handicapped Series—have received much less attention than Wiseman's earlier work, as if films about disability mark a drastic departure from his previous award-winning productions, such as Titicut Follies (1965) and Hospital (1970). The Multi-handicapped Series takes up general categories of disabled populations as discrete documentary topics, Deaf (1986), Blind (1986), Multi-handicapped (1986) and Adjustment & Work (1986) as opposed to a specific location as in his earlier films. As a result, the latter series of films identify social and interpersonal structures developed in the name of specific conditions. Like Foucault's research on disciplinary tactics, Wiseman's films seek out many of the segregated social spaces typically occupied by persons classified as deviant: prisons, hospitals, charity networks, sheltered workshops, resident facilities, and vocational training structures. The Multi-handicapped Series focuses on the activities of professions and practitioners in education, administration, and therapy, as well as the institutional roles designed for bodies marked as disabled. Unlike its 19th century predecessor classification, feebleminded, the latter twentieth century U.S. policy answer has been waged as a matter of dividing disabilities into a binary structure of orthopedic or cognitive categories. Such a development has left many crossover bodies in a diagnostic no-body's-land. To analyze the history of these developments, this essay recognizes the formation of today's disability category as an effect of new regimes of power; a form of domination based upon the application of particularized diagnostic pathologies that provide the basis for cordoning off bodies which fail to fit neatly within the cognitive/orthopedic binary. As documents of the social spaces that are occupied by disabled people, Wiseman's films offer a rare contemplation of institutional practices and their application to populations viewed as nonnormative.