Grounding the Unreal

The scientific successes of the last 400 years strongly suggest a picture on which our scientific theories exhibit a layered structure of dependence and determination. Economics is dependent on and determined by psychology; psychology in its turn is, plausibly, dependent on and determined by biology; and so it goes. It is tempting to explain this layered structure of dependence and determination among our theories by appeal to a corresponding layered structure of dependence and determination among the entities putatively treated by those theories. In this paper, I argue that we can resist this temptation: we can explain the sense in which, e.g., the biological truths are dependent on and determined by chemical truths without appealing to properly biological or chemical entities. This opens the door to a view on which, though there are more truths than just the purely physical truths, there are no entities, states, or properties other than the purely physical entities, states, and properties. I argue that some familiar strategies to explicate the idea of a layered structure of theories by appeal to reduction, ground, and truthmaking encounter difficulties. I then show how these difficulties point the way to a more satisfactory treatment which appeals to something very close to the notion of ground. Finally, I show how this treatment provides a theoretical setting in which we might fruitfully frame debates about which entities there really are.     

Standards for the Reporting of Genetic Counseling Interventions in Research and Other Studies (GCIRS): an NSGC Task Force Report

As the demand for evidence to support the value of genetic counseling increases, it is critical that reporting of genetic counseling interventions in research and other types of studies (e.g. process improvement or service evaluation studies) adopt greater rigor. As in other areas of healthcare, the appraisal, synthesis, and translation of research findings into genetic counseling practice are likely to be improved if clear specifications of genetic counseling interventions are reported when studies involving genetic counseling are published. To help improve reporting practices, the National Society of Genetic Counselors (NSGC) convened a task force in 2015 to develop consensus standards for the reporting of genetic counseling interventions. Following review by the NSGC Board of Directors, the NSGC Practice Guidelines Committee and the editorial board of the Journal of Genetic Counseling, 23 items across 8 domains were proposed as standards for the reporting of genetic counseling interventions in the published literature (GCIRS: Genetic Counseling Intervention Reporting Standards). The authors recommend adoption of these standards by authors and journals when reporting studies involving genetic counseling interventions.     

Physician Migration: Experience of International Medical Graduates in the USA

The purpose of this study was to explore the experience of foreign-born international medical graduates (IMGs) in the USA. Few studies describe IMG experiences in attaining medical licensure in the USA at each step of the process. Furthermore, little is known about IMGs who choose not to become a licensed physician or were unsuccessful in doing so. In this study, 20 foreign-born IMGs, 16 practicing IMGs and 4 non-licensed physician IMGs, participated in a 1-h semi-structured face-to-face interview between September 2013 and April 2014. Participants were from North America (Canada), Latin America, South Asia, East Asia, Europe, the Middle East, or Sub-Saharan Africa. Interviews were transcribed. Two of the authors conducted initial analysis of each interview separately. Four primary themes emerged based on the data analysis: (1) barriers to physician careers include the immigration process, years since graduating from medical school, language and culture, and cost and time; (2) positive factors to support physician careers include networking and research experience; (3) factors that positively or negatively affect IMGs seeking physician careers such as the education system in a home country and family; and (4) non-physician careers. In order to develop multiple pathways to utilize IMGs in the US healthcare system, future research examining the following areas is necessary: (1) support systems for IMGs who are taking the US Medical Licensing Exam (USMLE) or applying for a residency position and (2) the experience of IMGs who are not certified physicians in the USA.     

Religiosity and treatment response to antidepressant medication: A prospective multi-site clinical trial

The present study examined the relationship between religiosity/spirituality and treatment response to antidepressant medication (citalopram). One-hundred and forty-eight Caucasian and African-American adults with uncomplicated major depression were treated with citalopram (20-60mg/day) over an 8-week period in a prospective multi-site clinical trial. Treatment response was assessed weekly with the Hamilton Rating Scale for Depression. Religiosity (i.e., religious behaviours) and spirituality (i.e., spiritual well-being) were assessed at Week 3. No significant associations between spirituality and treatment response were found; however, there was a strong curvilinear relationship between religiosity and treatment response. Compared to lower or higher levels of religiosity, a moderate level of religiosity was significantly associated with a higher likelihood of remission and greater reduction in severity of depression. This association was independent of social support, ethnicity, gender, education, and baseline depression severity. A moderate amount of religiosity appears to be independently associated with an enhanced treatment response to citalopram.     

The bit in the middle and why it’s important: a computational analysis of the linguistic features of body paragraphs

This study examines the relationship between the linguistic characteristics of body paragraphs of student essays and the total number of paragraphs in the essays. Results indicate a significant relationship between the total number of paragraphs and a variety of linguistic characteristics known to affect student essay scores. These linguistic characteristics (e.g., semantic overlap, syntactic complexity) contribute to two underlying factors (i.e., textual cohesion and difficulty) that are used as dependent variables in mixed-effect models. Results suggest that student essays with 5-8 paragraphs tend to be more linguistically consistent than student essays with 3, 4, and 9 paragraphs. Essays with totals of 5-8 paragraphs, considered by many educators to contain an optimal number of paragraphs, may include functionally and structurally similar paragraphs. These findings could aid writing researchers and educators in obtaining a clearer view of the relationship between the total number of paragraphs comprising an essay and the linguistic characteristics that affect essay evaluation. Consequently, writing interventions may become better equipped to pinpoint student difficulties and facilitate student writing skills by providing more detailed and informed feedback.     

What is the Grounding Problem?

A philosophical standard in the debates concerning material constitution is the case of a statue and a lump of clay, Lumpl and Goliath respectively. According to the story, Lumpl and Goliath are coincident throughout their respective careers. Monists hold that they are identical; pluralists that they are distinct. This paper is concerned with a particular objection to pluralism, the Grounding Problem. The objection is roughly that the pluralist faces a legitimate explanatory demand to explain various differences she alleges between Lumpl and Goliath, but that the pluralist’s theory lacks the resources to give any such explanation. In this paper, I explore the question of whether there really is any problem of this sort. I argue (i) that explanatory demands that are clearly legitimate are easy for the pluralist to meet; (ii) that even in cases of explanatory demands whose legitimacy is questionable the pluralist has some overlooked resources; and (iii) there is some reason for optimism about the pluralist’s prospects for meeting every legitimate explanatory demand. In short, no clearly adequate statement of a Grounding Problem is extant, and there is some reason to believe that the pluralist can overcome any Grounding Problem that we haven’t thought of yet.     

Evidence-based mental health interventions for traumatized youth: a statewide dissemination project

Psychological trauma in childhood has been shown to increase a variety of psychological disturbances and psychiatric disorders. Although evidence-based treatments for children who have been traumatized exist, they are infrequently used by clinicians treating children. The present paper describes the creation of the Treatment Collaborative for Traumatized Youth (TCTY) which is a statewide partnership in North Dakota designed to disseminate efficacious treatments for traumatized children and monitor outcomes across a broad, rural, geographic expanse. The paper reviews the dissemination strategy developed by the TCTY, reports outcomes regarding both clinicians and child participants, and highlights problems identified in the project and solutions that were generated.     

Neurobiological and memory models of risky decision making in adolescents versus young adults

Predictions of fuzzy-trace theory and neurobiological approaches are examined regarding risk taking in a classic decision-making task--the framing task--as well as in the context of real-life risk taking. We report the 1st study of framing effects in adolescents versus adults, varying risk and reward, and relate choices to individual differences, sexual behavior, and behavioral intentions. As predicted by fuzzy-trace theory, adolescents modulated risk taking according to risk and reward. Adults showed standard framing, reflecting greater emphasis on gist-based (qualitative) reasoning, but adolescents displayed reverse framing when potential gains for risk taking were high, reflecting greater emphasis on verbatim-based (quantitative) reasoning. Reverse framing signals a different way of thinking compared with standard framing (reverse framing also differs from simply choosing the risky option). Measures of verbatim- and gist-based reasoning about risk, sensation seeking, behavioral activation, and inhibition were used to extract dimensions of risk proneness: Sensation seeking increased and then decreased, whereas inhibition increased from early adolescence to young adulthood, predicted by neurobiological theories. Two additional dimensions, verbatim- and gist-based reasoning about risk, loaded separately and predicted unique variance in risk taking. Importantly, framing responses predicted real-life risk taking. Reasoning was the most consistent predictor of real-life risk taking: (a) Intentions to have sex, sexual behavior, and number of partners decreased when gist-based reasoning was triggered by retrieval cues in questions about perceived risk, whereas (b) intentions to have sex and number of partners increased when verbatim-based reasoning was triggered by different retrieval cues in questions about perceived risk.     

The construction of self-injury in the clinical literature: a sociological exploration

This article presents a sociologically informed critique of a range of academic literatures relating to self-injury. It is noted how a lack of consensus on definitional issues, together with the inaccurate portrayal of the "typical self-injurer" in the clinical literature, has impeded the development of a sound understanding of self-injury. Some of the more problematic explanations for self-injury are explored. The individualistic focus of existing research is found to be inadequate, since it fails to account for the social context in which self-injury occurs. Social scientific approaches critically examine psychiatric and psychological constructions of self-injury, explore wider social and cultural meanings of the behavior, and examine its distribution across different social groups. The inclusion of social scientific perspectives into current debates will greatly improve understanding of self-injury.