Enhancing the care of children with chronic diseases through the narratives of patient,physician, nurse and carer

We tested the hypothesis that a narrative approach may enhance a bio‐psycho‐social model (BPS) in caring for chronically ill children. Forty‐eight narratives were collected from 12 children with six different medical conditions, their mothers, physicians, and nurses. By a textual analysis, narratives were classified on their predominant focus as disease (biological focus), illness (psychologic focus), or sickness (social focus). Sixty‐one percent of narrative’ text were classified as illness, 28% as disease and 11% as sickness. All narratives had a degree of illness focus. Narratives by patients and physicians on the one hand, and nurses’ and mothers’ on the other were disease focused. Narratives were also evaluated with respect to the type of medical condition: Illness was largely prevalent in all but Crohn’s disease and HIV infection, the latter having a predominance of sickness most probably related to stigma. Narrative exploration proved a valuable tool for understanding and addressing the needs of children with complex conditions. Narrative approaches allow identification of the major needs of different patients according to health conditions and story tellers. In the narratives, we found a greater illness and disease focus and surprisingly a low sickness focus, except with HIV stories. Narrative medicine provides a tool to strengthen the BPS model in health care.     

What is agentic about the Spatial Agency Bias? How pragmatic relevance contributes to the spatial representations of actions

The mental imagination of (social) actions has been shown to follow a left‐to‐right trajectory, with the thematic agent associated with the left position (Spatial Agency Bias, Suitner & Maass in Advances in Experimental Social Psychology, 53, 2016, p. 245–301). For example, individuals asked to choose a picture that visualizes the sentence “Tom kicks George” tend to choose an image where the agent, Tom, is positioned on the left‐hand side rather than on the right‐hand side. However, as an alternative to the thematic role of the agent, such findings may reflect a mental representation following pragmatic relevance. Specifically, a pragmatic perspective holds that word order and syntactic functions are strategic devices to communicate that the element is important for the sentence. Thus, positioning in the described picture‐matching task may actually reflect the agent's pragmatic relevance instead of agency per se. As a test, we vary whether sentences are written in the active versus the passive voice. Results from five studies indicate that the passive voice results in the tendency to place the agent on the right‐hand side rather than on the left‐hand side of a picture. Instead, the acted‐upon person is positioned on the left‐hand side of a picture. A sixth experiment reveals that for the passive voice, the agent is still seen as more agentic than the receiver, but is considered less relevant. The findings are congruent with the proposed pragmatic relevance account. Implications for the Spatial Agency Bias as well as for building mental representations in general are discussed.     

Counterexample Search in Diagram-Based Geometric Reasoning

Topological relations such as inside, outside, or intersection are ubiquitous to our spatial thinking. Here, we examined how people reason deductively with topological relations between points, lines, and circles in geometric diagrams. We hypothesized in particular that a counterexample search generally underlies this type of reasoning. We first verified that educated adults without specific math training were able to produce correct diagrammatic representations contained in the premisses of an inference. Our first experiment then revealed that subjects who correctly judged an inference as invalid almost always produced a counterexample to support their answer. Noticeably, even if the counterexample always bore a certain level of similarity to the initial diagram, we observed that an object was more likely to be varied between the two drawings if it was present in the conclusion of the inference. Experiments 2 and 3 then directly probed counterexample search. While participants were asked to evaluate a conclusion on the basis of a given diagram and some premisses, we modulated the difficulty of reaching a counterexample from the diagram. Our results indicate that both decreasing the counterexample density and increasing the counterexample distance impaired reasoning performance. Taken together, our results suggest that a search procedure for counterexamples, which proceeds object-wise, could underlie diagram-based geometric reasoning. Transposing points, lines, and circles to our spatial environment, the present study may ultimately provide insights on how humans reason about topological relations between positions, paths, and regions.     

Human Self-Domestication and the Evolution of Pragmatics

As proposed for the emergence of modern languages, we argue that modern uses of languages (pragmatics) also evolved gradually in our species under the effects of human self-domestication, with three key aspects involved in a complex feedback loop: (a) a reduction in reactive aggression, (b) the sophistication of language structure (with emerging grammars initially facilitating the transition from physical aggression to verbal aggression); and (c) the potentiation of pragmatic principles governing conversation, including, but not limited to, turn-taking and inferential abilities. Our core hypothesis is that the reduction in reactive aggression, one of the key factors in self-domestication processes, enabled us to fully exploit our cognitive and interactional potential as applied to linguistic exchanges, and ultimately to evolve a specific form of communication governed by persuasive reciprocity—a trait of human conversation characterized by both competition and cooperation. In turn, both early crude forms of language, well suited for verbal aggression/insult, and later more sophisticated forms of language, well suited for persuasive reciprocity, significantly contributed to the resolution and reduction of (physical) aggression, thus having a return effect on the self-domestication processes. Supporting evidence for our proposal, as well as grounds for further testing, comes mainly from the consideration of cognitive disorders, which typically simultaneously present abnormal features of self-domestication (including aggressive behavior) and problems with pragmatics and social functioning. While various approaches to language evolution typically reduce it to a single factor, our approach considers language evolution as a multifactorial process, with each player acting upon the other, engaging in an intense mutually reinforcing feedback loop. Moreover, we see language evolution as a gradual process, continuous with the pre-linguistic cognitive abilities, which were engaged in a positive feedback loop with linguistic innovations, and where gene-culture co-evolution and cultural niche construction were the main driving forces.     

Socially Situated Transmission: The Bias to Transmit Negative Information is Moderated by the Social Context

Cultural evolutionary theory has identified a range of cognitive biases that guide human social learning. Naturalistic and experimental studies indicate transmission biases favoring negative and positive information. To address these conflicting findings, the present study takes a socially situated view of information transmission, which predicts that bias expression will depend on the social context. We report a large-scale experiment (N = 425) that manipulated the social context and examined its effect on the transmission of the positive and negative information contained in a narrative text. In each social context, information was progressively lost as it was transmitted from person to person, but negative information survived better than positive information, supporting a negative transmission bias. Importantly, the negative transmission bias was moderated by the social context: Higher social connectivity weakened the bias to transmit negative information, supporting a socially situated account of information transmission. Our findings indicate that our evolved cognitive preferences can be moderated by our social goals.     

Empirical Evidence for Extended Cognitive Systems

We present an empirically supported theoretical and methodological framework for quantifying the system-level properties of person-plus-tool interactions in order to answer the question: “Are person-plus-tool-systems extended cognitive systems?” Nineteen participants provided perceptual judgments regarding their ability to pass through apertures of various widths while using visual information, blindfolded wielding a rod, or blindfolded wielding an Enactive Torch—a vibrotactile sensory-substitution device for detecting distance. Monofractal, multifractal, and recurrence quantification analyses were conducted to assess features of person-plus-tool movement dynamics. Trials where people utilized the rod or Enactive Torch demonstrated stable “self-similarity,” or indices of healthy and adaptive single systems, regardless of aperture width, trial order, features of the participants’ judgments, and participant characteristics. Enactive Torch trials exhibited a somewhat greater range of dynamic fluctuations than the rod trials, as well as less movement recurrence, suggesting that the Enactive Torch allowed for more exploratory movements. Findings provide support for the notion that person-plus-tool systems can be classified as extended cognitive systems and a framework for quantifying system-level properties of these systems. Implications concerning future research on extended cognition are discussed.     

Dynamics Versus Development in Numerosity Estimation: A Computational Model Accurately Predicts a Developmental Reversal

Perceptual judgments result from a dynamic process, but little is known about the dynamics of number-line estimation. A recent study proposed a computational model that combined a model of trial-to-trial changes with a model for the internal scaling of discrete numbers. Here, we tested a surprising prediction of the model—a situation in which children's estimates of numerosity would be better than those of adults. Consistent with the model simulations, task contexts led to a clear developmental reversal: children made more adult-like, linear estimates when to-be-estimated numbers were descending over trials (i.e., backward condition), whereas adults became more like children with logarithmic estimates when numbers were ascending (i.e., forward condition). In addition, adults’ estimates were subject to inter-trial differences regardless of stimulus order. In contrast, children were not able to use the trial-to-trial dynamics unless stimuli varied systematically, indicating the limited cognitive capacity for dynamic updates. Together, the model adequately predicts both developmental and trial-to-trial changes in number-line tasks.     

CHRISTIANITY,SCIENCE, AND THREE PHASES OF BEING HUMAN

The alleged conflict between religion and science most pointedly focuses on what it is to be human. Western philosophical thought regarding this has progressed through three broad stages: mind/body dualism, Neo‐Darwinism, and most recently strong artificial intelligence (AI). I trace these views with respect to their relation to Christian views of humans, suggesting that while the first two might be compatible with Christian thought, strong AI presents serious challenges to a Christian understanding of personhood, including our freedom to choose, moral choice itself, self‐consciousness, and the relevance of God to our beginning, being, and ending.     

Quitters would not prosper: Examining the relationship between online assessment performance and assessment attrition behavior

Hiring managers are often hesitant to implement online assessments over concerns that higher‐quality candidates are more likely to quit lengthy assessment batteries than lower‐quality candidates. In this paper, we present the results of two studies that collectively challenge this assumption. In Study 1, data from 327,517 job‐seekers spanning eight hiring contexts showed that assessment performance was negatively associated with subsequent assessment attrition behavior. In Study 2, we replicated this pattern of effects in two additional samples comprising 1,844,604 applicants for hourly associate positions, and 18,937 applicants for nursing positions. Collectively, these findings suggest that some degree of attrition may ultimately benefit, rather than harm, organizations using prehire assessments.