Foundations of clinical praxiology part II: Categorical and conjectural diagnoses

The concepts of categorical diagnosis and conjectural diagnosis are introduced. It is argued that in diagnostic reasoning conjectural diagnosis plays a more important role than categorical diagnosis. Attention is called to the inevitable vagueness of clinical language and to the suitability of epistemic logic and fuzzy logic for diagnostic reasoning.     

Clamped Corticosterone (B) Reveals the Effect of Endogenous B on Both Facilitated Responsivity to Acute Restraint and Metabolic Responses to Chronic Stress

To determine the effects of both corticosterone (B) and chronic stressors on acute ACTH responses to restraint, young male rats were exposed to streptozotocin-induced diabetes, cold (5-7 degreesC) or intracerebroventricular (icv) neuropeptide Y (NPY) for 5 d and then exposed to restraint within 2 h after lights on. Two groups of rats were studied: intact and adrenalectomized replaced with B pellets that maintained plasma B in the normal mean 24-h range of intact rats. In addition to ACTH and B responses to restraint on d 5, body weight, food intake, fat depots, glucose and other hormones were measured to determine the role of stress-induced elevations in B on energy balance. ACTH responses to restraint were normal in intact rats subjected to diabetes or cold. By contrast, there was no ACTH or B response to restraint in NPY-infused intact rats. All 3 groups of chronically stimulated adrenalectomized rats with clamped B had facilitated ACTH responses to restraint compared to their treatment controls. Overall food intake increased in all groups of stressed rats; however, augmented intake occurred only during the light in intact rats and equally in the light and dark in B-clamped rats. White adipose depot weights were decreased by both diabetes and cold and increased by NPY in intact rats; the decreases with cold and increases with NPY were both blunted and changes in fat stores were not significant in adrenalectomized, B-clamped rats. We conclude that: 1. diabetes- and cold-induced facilitation of restraint-induced afferent input to hypothalamic control of the hypothalamo-pituitary-adrenal (HPA) axis is opposed in intact rats by the elevated feedback signal of B secretion; 2. NPY does not induce facilitation of afferent stress pathways; 3. chronic stimulation of the HPA axis induces acute hyperresponsiveness of hypothalamic neurons to restraint provided that the afferent input of this acute stimulus is not prevented by B feedback; 4. stimulus-induced elevations in B secretion result in day-time feeding; 5. insensitivity of both caloric efficiency and white fat stores to chronic stress in adrenalectomized, B-clamped rats results from loss of normally variable B levels.     

Perception,illusion, and hallucination

Patrick Suppes' set-theoretical approach to the analysis of theories, and Joseph D. Sneed's metatheory are briefly outlined. The notions of observation, illusion and hallucination are reconstructed according to these approaches. It is argued that the terms ‘perception’ and ‘truth’ are theoretical with respect to observation but nontheoretical with respect to illusion and hallucination. Hallucination is construed as a special kind of illusion.     

Sad and happy emotion discrimination in music by children with cochlear implants

Children using cochlear implants (CIs) develop speech perception but have difficulty perceiving complex acoustic signals. Mode and tempo are the two components used to recognize emotion in music. Based on CI limitations, we hypothesized children using CIs would have impaired perception of mode cues relative to their normal hearing peers and would rely more heavily on tempo cues to distinguish happy from sad music. Study participants were children with 13 right CIs and 3 left CIs (M = 12.7, SD = 2.6 years) and 16 normal hearing peers. Participants judged 96 brief piano excerpts from the classical genre as happy or sad in a forced-choice task. Music was randomly presented with alterations of transposed mode, tempo, or both. When music was presented in original form, children using CIs discriminated between happy and sad music with accuracy well above chance levels (87.5%) but significantly below those with normal hearing (98%). The CI group primarily used tempo cues, whereas normal hearing children relied more on mode cues. Transposing both mode and tempo cues in the same musical excerpt obliterated cues to emotion for both groups. Children using CIs showed significantly slower response times across all conditions. Children using CIs use tempo cues to discriminate happy versus sad music reflecting a very different hearing strategy than their normal hearing peers. Slower reaction times by children using CIs indicate that they found the task more difficult and support the possibility that they require different strategies to process emotion in music than normal.     

Creativity Development of High-Achieving Students

Few studies on creativity have focused on creativity development in various grade levels for high-achieving students. The purpose of this study was to explore the developmental trajectories of creative ability for high-achieving students. The participants constituted a national representative sample of 982 male (N = 506) and female (484) students from grades 1 to 10 in five governorates in Oman (Muscat, South-Al Batinah, South- Al Sharqia, Dhofar, and Al Dhakilia). The students completed two subtests of the Profile of Creative Abilities (PCA), a measure of creative potential, namely drawings and categories. There was an evidence of a developmental trend of creativity across grade levels. The Multi-variate analysis of variance (MANOVA) showed that the main effect of grade was statistically significant for the drawings subtest. Also, the main effect of gender was also statistically significant for the drawings subtest. The main effect of interaction (gender X grade) was not significant. Overall, females’ creative performance was significantly better than males’ in the Creativity Index score. The results of the study are discussed in the light of existing literature about developmental trends and gender differences in creative thinking.     

Normative systems and medical metaethics Part II: Health-maximizing and persons

Two common medical-ethical axions, the health-maximizing axiom and the personhood-respecting axiom, are discussed. On the basis of a philosophical analysis of personhood and freedom of the will it is shown that these two axioms are incompatible. The rejection of the first axiom is suggested.     

The three paradoxes lost a response to Moore and Hutchins

Moore and Hutchin's [1] assertion that the application of classical logic as the method of diagnostic reasoning may result in three paradoxes is critically examined.     

阅读预期对快速阅读理解的影响的实验研究

探讨阅读预期对快速阅读的理解水平与进程的影响。实验１探讨阅读预期对快速阅读理解水平的影响。阅读文章前分别给予被试正确、中性与误导的标题提示,结果表明,不同类型的标题提示对快速阅读的理解成绩有显著的影响,而对正常速度阅读的理解成绩影响效果不显著。实验２探讨阅读预期对快速阅读过程的词句加工程度的影响。结果表明,对优生来说,正确标题提示组发现文章中锗字的成绩显著低于误导标题提示组,差生的不同标题提示组发现错字的成绩差异不显著。两个实验的结果初步表明,快速阅读文章过程会更多地利用概念推动,较少地需要材料信息。