Information constraints in medical encounters

This article describes three kinds of information constraints in medical encounters that have not been discussed at length in the medical ethics literature: constraints from the concept of a disease, from the diffusion of medical innovation, and from withholding information. It describes how these limit the reliance rational people can justifiably put in their doctors, and even the reliance doctors can have on their own advice. It notes the implications of these constraints for the value of informed consent, identifies several procedural steps that could increase the value of the latter and improve diffusion of innovation, and argues that recognition of these constraints should lead us to devise protections which intrude on but can improve these encounters.     

A Review of Gerald Caplan's Theory and Practice of Mental Health Consultation

Gerald Caplan's Theory and Practice of Mental Health Consultation (1970), considered to be a classic seminal work in the field of consultation, is reviewed. First, the author presents Caplan's general definition of consultation along with what may be considered the general principles or procedures of consultation. Then the author presents Caplan's procedures and principles as relevant to each type of consultation. Next, each of Caplan's four models of consultation is described. Last, these four models are compared in terms of the professional role of the consultee, the primary goal of consultation, and the target of consultation intervention.     

Demonstration of an aftereffect occurring in the tactile-kinesthetic domain

Summary The aim of this work is the demonstration of a tactile-kinesthetic aftereffect. A sequence of stimuli was offered to adult subjects whose task was to compare two weights presented simultaneously to both hands by means of a Piéron gravimeter. In Experiment 1 the inspection stimuli consisted of two successive presentations of unequal weights for a period of 2 × 10 s. The test stimuli consisted of two equal weights rapidly following an inspection stimulus. Control stimuli consisting of two equal weights not preceded by an inspection stimulus were interspersed in the sequence. The results obtained confirm the existence of a contrast effect after presentation of an inspection stimulus. In Experiment 2 the inspection stimuli consisted of a single presentation of two unequal weights for a period of 20 s. The results confirm those of the first experiment and provide data enabling the contrast effect obtained to be interpreted as a Köhler-type aftereffect. In order to avoid confusion with the kinesthetic-figural aftereffect, we propose to call the effect demonstrated here the Gravimetric Aftereffect.     

A note on the estimation of the level of predictive precision of a fitted linear equation

A procedure that utilizes the sample multiple correlation to form a lower bound for the level of predictive precision of a fitted regression equation is suggested. The procedure is shown to yield probability statements which are true at least 100(1–)% of the time.     

mMotiv8: A smartphone‐based contingency management intervention to promote smoking cessation

Cigarette smoking is the leading preventable cause of death and illness in the United States. We tested the usability, acceptability, and efficacy of a smartphone‐based contingency management treatment to promote cessation. We used a nonconcurrent multiple‐baseline design. Participants (N = 14) provided breath carbon monoxide (CO) samples by using a CO meter that was connected to the user's smartphone. An app (mMotiv8) housed on participants' smartphones automatically captured pictures of the CO sampling procedure to validate the end user's identity, and it prompted submissions via a push message delivered to participants' smartphones. Participants earned a $10 incentive for daily abstinence, which was added to a reloadable debit card. Overall, 4% of the CO samples were negative during baseline, and 89% were negative during treatment. Self‐reported usability and acceptability were high, and 85% of the prompted samples were submitted. A smartphone intervention could be scalable and reduce the health consequences and costs associated with cigarette smoking, particularly in rural and low‐income populations.     

Learning to optimize speed, accuracy, and energy expenditure: a framework for understanding speed-accuracy relations in goal-directed aiming

Over the last century, investigators have developed a number of models to explain the relation between speed and accuracy in target-directed manual aiming. The models vary in the extent to which they stress the importance of feedforward processes and the online use of sensory information (see D. Elliott, W. F. Helsen, & R. Chua, 2001, for a recent review). A common feature of those models is that the role of practice in optimizing speed, accuracy, and energy expenditure in goal-directed aiming is either ignored or minimized. The authors present a theoretical framework for understanding speed-accuracy tradeoffs that takes into account the strategic, trial-to-trial behavior of the performer. The strategic behavior enables individuals to maximize movement speed while minimizing error and energy expenditure.     

Phonological underspecification and mapping mechanisms in the speech recognition lexicon

The problem of recognizing phonological variations in the speech input has triggered numerous treatments in speech processing models. Two areas of current controversy are the possibility of phonological underspecification in the mental lexicon and the nature of the mapping mechanism from the speech signal to the abstract lexical entry. We present data from cross-modal repetition priming experiments in English designed to test the differing predictions of speech recognition models regarding tolerance of phonological mismatch in speech. The results show effects of underspecification, supporting models using underspecified lexical entries (e.g. Lahiri & Marslen-Wilson, 1991; Reetz & Lahiri, 2001) over those using fully specified lexical entries (e.g., McClelland & Elman, 1986). The results also show no effects of context, thus favoring context-independent mapping, such as that in the three-way matching mechanism of the Lahiri and Reetz FUL model ( Lahiri, 1999; Reetz, 1998 and Reetz, 1999; Reetz & Lahiri, 2001) over context-dependent mapping used in phonological inference rules ( Gaskell and Marslen-Wilson, 1996 and Gaskell and Marslen-Wilson, 1998).     

Prolactin and paternal care: comparison of three species of monogamous new world monkeys (Callicebus cupreus,Callithrix jacchus,and Callimico goeldii)

The authors explored whether prolactin is associated with paternal care in 3 monkey species: titi monkey (Callicebus cupreus), common marmoset (Callithrix jacchus), and Goeldi's monkey (Callimico goeldii). They compared prolactin levels in fathers before and after infant birth as well as between fathers and nonfathers. C. cupreus fathers carry infants almost exclusively, have higher prolactin levels than nonfathers, but show no prolactin increase after infant birth. C. goeldii fathers carry infants only after 3 weeks, show an increase in prolactin levels during the precarrying period, but do not have higher levels than nonfathers. C jacchus fathers are the primary carriers, have higher prolactin levels than nonfathers, and show a trend for a prolactin increase after the birth of infants. In conclusion, species differences in the patterns of prolactin secretion were evident and reflect the different paternal roles.     

Amygdalectomy and responsiveness to novelty in rhesus monkeys (Macaca mulatta): generality and individual consistency of effects

Rhesus monkeys (Macaca mulatta) with bilateral ibotenic acid-produced lesions of the amygdala were compared with controls in several novel situations, including exposures to metal objects, toy animals, and a person. Early in testing, the monkeys with lesions showed reduced inhibitions on responsiveness compared with controls. With continuing exposures, differences between groups diminished sharply as inhibitions waned in the controls. This outcome is consistent with the hypothesis that the amygdala mediates caution in initial reactions to ambiguous or threatening novel situations, which, in the absence of adverse consequences, diminishes with repetition. Consistency of individual responsiveness across different situations, including pairing with other monkeys, was substantial in lesioned and normal monkeys, suggesting that stable qualities of temperament influenced the results in both groups.     

Routes to Symbolization: Intentionality and Correspondence in Early Understanding of Pictures

This research investigated the extent and nature of the informational support that enables young children to understand pictures as symbols. Two experiments were conducted using an object-retrieval task. The first experiment varied the amount (complete and no instructions) and kind of information (intended function of the symbol and picture-referent correspondence) provided to 30-month-old children. The results show that information which emphasizes intentionality was critical for symbolic comprehension. Although information about correspondence was not enough in itself, children came to achieve an insight halfway through the task, probably as a consequence of a comparison process. This study suggests that highlighting the heart of the symbolic relation, its intended function, is a privileged route in children's appreciation of a picture-referent relation. The second experiment shows that by 36 months of age, children figured out, with no instructions at all, the intentional nature of the symbol.