This study investigates the aptitude–treatment interaction between text modality and learners’ modality preference on learning outcomes and cognitive load, which is currently a point of controversy. The Meshing Hypothesis postulates there are better learning outcomes when the modality of a learning environment matches the learner´s preference. However, previous research supporting the Meshing Hypothesis shows methodological issues. Therefore, clear empirical support is needed. We tested 42 learners in a between-subject design: Their preferences were either auditive–ambiguous or visual, and (...) half of each preference group randomly learned either with an auditive or a visual text. As expected, we did not find any main effects, but a significant interaction between the text modality and the learner´s preference for comprehension outcomes, extraneous cognitive load, and germane cognitive load. Specifically, learners with a preference for visual texts benefit from learning with their preferred modality, they showed higher comprehension scores and less extraneous load when learning from a visual text. Auditive–ambiguous learners showed almost equal results with both text modalities. This might be explained by the fact that most texts in everyday life are presented visually, and therefore learners with an auditive preference needed to develop appropriate reading strategies. Thus, our results partly support the Meshing Hypothesis. (shrink)

This study investigates how background music influences learning with respect to three different theoretical approaches. Both the Mozart effect as well as the arousal-mood-hypothesis indicate that background music can potentially benefit learning outcomes. While the Mozart effect assumes a direct influence of background music on cognitive abilities, the arousal-mood-hypothesis assumes a mediation effect over arousal and mood. However, the seductive detail effect indicates that seductive details such as background music worsen learning. Moreover, as working memory capacity has a crucial influence (...) on learning with seductive details, we also included the learner’s working memory capacity as a factor in our study. We tested 81 college students using a between-subject design with half of the sample listening to two pop songs while learning a visual text and the other half learning in silence. We included working memory capacity in the design as a continuous organism variable. Arousal and mood scores before and after learning were collected as potential mediating variables. To measure learning outcomes we tested recall and comprehension. We did not find a mediation effect between background music and arousal or mood on learning outcomes. In addition, for recall performance there were no main effects of background music or working memory capacity, nor an interaction effect of these factors. However, when considering comprehension we did find an interaction between background music and working memory capacity: the higher the learners’ working memory capacity, the better they learned with background music. This is in line with the seductive detail assumption. (shrink)

_Background:_ Several studies have shown a connection between mothers with postnatal depression (PND) and emotional-behavioral problems in their children. Mothers’ psychopathology may impair interactional patterns with children and these outcomes can be influenced by father’s psychopathological symptoms. The primary aim of the study was to assess over time parent-infant interaction in families where mothers have experienced PND and have received psychological treatment during the child’s first year of life considering the severity of parents’ psychopathological symptoms and children’s temperament. (...) _Methods:_ Three groups of families were involved: families with mothers with PND wherein both parents followed a psychological treatment (TxMF); families with mothers affected by PND wherein only the mother followed the treatment (TxM) and control families wherein the mothers did not have a psychopathological diagnosis and did not receive any treatment (Con). The families were assessed at two time points through Symptom Check-List-90-Revised (SCL-90-R), Questionari Italiani Temperamento (QUIT) and the video-recorded procedure observing mealtime Scala di Valutazione Interazioni Alimentari (SVIA). _Results:_ Parents in the TxMF group had significantly lower SVIA scores (i.e., less maladaptive) at T2. TxMF group scored lower at T2 at SCL-90-R, whereas TxM showed no significant differences between T1 and T2. Involvement of fathers in the treatment was important to improve the psychopathological symptoms of both parents and the quality of interactions with their children. (shrink)

In recent years, several studies have advocated the need to expand the concept of patient autonomy beyond the capacity to deliberate and make decisions regarding a specific medical intervention or treatment (decision-making or decisional autonomy). Arguing along the same lines, this paper proposes a multidimensional concept of patient autonomy (decisional, executive, functional, informative and narrative) and argues that determining the specific aspect of autonomy affected is the first step towards protecting or promoting (and respecting) patient autonomy. These different manifestations (...) of autonomy are not mutually dependent; there may be patients who have problems in one dimension, while at the same time being fully autonomous in others. Nevertheless, a close interaction has been observed between the various dimensions and indeed, a phenomenological analysis shows that damage to or a reduction in one aspect of people’s capacity for self-government generally affects other aspects of their autonomy, which in turn disrupts their identity and the way in which they see themselves and are seen by others. In this paper, I shall examine some of these interactions and show how they may lie at the heart of the problem of poor treatment adherence (where adherence is defined as being the extent to which a patient’s behavior over time coincides with the recommendations made by and agreed with their health professional). One example given is that of psoriasis, a chronic skin disease with a very poor adherence record. In Spain, it is calculated that 85% of patients diagnosed with mild to moderate psoriasis fail to comply properly with their treatment, and figures from other parts of the world are similar. Although there are many possible causes for non-adherence among psoriasis patients, assessing their decisional, executive and narrative capacities and taking appropriate action based on the results may help increase adherence rates. (shrink)

Newly developed techniques for anaesthesia and asepsis made it possible for surgeons to attempt operative attacks on diseases which had been previously incurable. The period around the turn of the century is sometimes portrayed as one of very active development of new surgical methods. This activity has been seen as a result of fertile scientific thinking. It is demonstrated in the paper that it was in fact a barren period with a prolonged adherence to an anatomical concept as the basis (...) for problem solving. It is described in terms of Kuhnian periods of normal activity and crisis. It took about fifty years before theory and practice were harmonized under a physiological concept and real progress was made. (shrink)

This study explores how disciplinary humor is deployed to shape and reshape social order in inter-generational encounters. Data are drawn from an ethnographic study of staff–resident encounters at a treatment home for boys, focusing on sequential patterns in the local design of jokes and teasing, analyzing language and multimodal interaction in detail. It was found that staff and boys recurrently laughed together and teased each other by invoking local hierarchical positions such as child–adult. The intrinsic ambiguity of humor (...) and teasing allowed staff members to engage in temporary breaches of social order, while simultaneously enforcing local rules of conduct. Similarly, the boys would joke with the staff, exaggerating or transgressing institutional and generational divides. But ultimately, the joking could also be seen to remind the participants of the very hierarchies that separate staff from residents and men from boys, or adults from children. (shrink)

The purpose of this study was to apply deep learning to music perception education. Music perception therapy for autistic children using gesture interactive robots based on the concept of educational psychology and deep learning technology is proposed. First, the experimental problems are defined and explained based on the relevant theories of pedagogy. Next, gesture interactive robots and music perception education classrooms are studied based on recurrent neural networks. Then, autistic children are treated by music perception, and an electroencephalogram is used (...) to collect the music perception effect and disease diagnosis results of children. Due to significant advantages of signal feature extraction and classification, RNN is used to analyze the EEG of autistic children receiving different music perception treatments to improve classification accuracy. The experimental results are as follows. The analysis of EEG signals proves that different people have different perceptions of music, but this difference fluctuates in a certain range. The classification accuracy of the designed model is about 72–94%, and the average classification accuracy is about 85%. The average accuracy of the model for EEG classification of autistic children is 85%, and that of healthy children is 84%. The test results with similar models also prove the excellent performance of the design model. This exploration provides a reference for applying the artificial intelligence technology in music perception education to diagnose and treat autistic children. (shrink)

Le deuil a été largement étudié par la psychanalyse. L’aptitude à la séparation mère-bébé l’est également par les spécialistes du développement infantile. Nous souhaitons former des ponts entre ces deux épistémologies pour démontrer que l’aptitude à la séparation permet la prédisposition au deuil. L’aptitude à la séparation résulte de la cessation de l’état fusionnel mère-bébé qui permet l’établissement de l’intersubjectivité puis de la subjectivité. Le rythme des interactions mère-bébé donne accès à la temporalité. Ces étapes sont essentielles (...) pour le travail de la pensée nécessaire au deuil. Le bébé dont la mère est déprimée dès la naissance ne pourra pas développer son aptitude à la séparation dans une perpétuelle attitude de stimulation. L’enfant qui connaît la dépression maternelle aura les plus grandes difficultés à accepter son ambivalence. Nos illustrations thérapeutiques témoignent qu’il est possible maintenant de proposer une prévention de la dépression maternelle en maternité ou en pédiatrie. (shrink)

APPENDIX: The data emerging from the clinical and brain studies described above suggest that, in the case of OCD, there are two pertinent brain mechanisms that are distinguishable both in terms of neuro-dynamics and in terms of the conscious experiences that accompany them. These mechanisms can be characterized, on anatomical and perhaps evolutionary grounds, as a lower-level and a higher-level mechanism. The clinical treatment has, when successful, an activating effect on the higher-level mechanism, and a suppressive effect on the (...) lower-level one. (shrink)

In clinical trials, it is common practice to follow up significant interactions between the factors under investigation with subgroup analyses. Such analyses pose at least two analytical and interpretational challenges. The first challenge is that performing multiple subgroup analyses increases the likelihood of obtaining spuriously significant results. This has been acknowledged and relevant guidance exists in the medical literature. The second challenge is that the effects that are obtained at the level of subgroup are composite. This has yet to be (...) fully acknowledged and discussed in the context of medical research. This paper aims to fill this lacuna. Using a simple additive model, we use recent findings from the CHARISMA trial on the efficacy of clopidogrel in addition to aspirin in the treatment of patients at risk for atherothrombotic events to demonstrate quantitatively the composition of effects at the level of subgroups. In the simplest case of a design involving an interaction (two crossed factors, with two levels each, i.e. a 2 x 2 design), effects at the level of subgroup consist of influences that stem (i) from the incidence of the measured outcome in the study population as a whole; (ii) from the factor of interest (e.g. treatment vs. placebo); (iii) from the second factor (e.g. patient group membership); (iv) from the interaction between the two factors; and (v) from random error in the measured outcome. The value of the approach illustrated here is that it is generalizable to any research design irrespective of its complexity and that it prompts clinicians to consider the multiple causality underlying medical research findings. (shrink)

This paper empirically investigates the interaction between repeated transactions and endogenous contractual incompleteness. We design an indefinitely repeated games experiment between identifiable players. In this experiment, the probability of continuation and the level of shared information vary over the treatments. The level of contractual completeness is decided by participants at each period. Our results show that past interactions are a stronger determinant of the level of investment in contractual completeness than the perspective of future business.

_Clinical Interaction and the Analysis of Meaning_ evinces a therapeutic vitality all too rare in works of theory. Rather than fleeing from the insights of other disciplines, Dorpat and Miller discover in recent research confirmation of the possibilities of psychoanalytic treatment. In Section I, "Critique of Classical Theory," Dorpat proposes a radical revision of the notion of primary process consonant with contemporary cognitive science. Such a revised conception not only enlarges our understanding of the analytic process; it also (...) provides analysis with a conceptual language that can articulate meaningful connections with a growing body of empirical research about the development and nature of human cognition. In Section II, "Interactional Theory," Miller reverses the direction of inquiry. He begins with the literature on cognitive development and functioning, and proceeds to mine it for concepts relevant to the clinical process. He shows how a revised understanding of the operation of cognition and affect can impart new meaning to basic clinical concepts such as resistance, transference, and level of psychopathology. In Section III, "Applications and Exemplifications," Dorpat concludes this exemplary collaboration by exploring select topics from the standpoint of his and Miller's new psychoanalytic theory. At the heart of the authors' endeavor it "meaning analysis," a concept that integrates an up-to-date model of human information processing with the traditional goals of psychoanalysis. The patient approaches the clinical encounter, they argue, with cognitive-affective schemas that are the accumulatice product of his life experience to date; the manifold meanings ascribed to the clinical interaction must be understood as the product of these schemas rather than as distortions deriving from unconscious, drive-related fantasies. The therapist's goal is to make the patient's meaning-making conscious and thus available for introspection. (shrink)

Despite wide recognition of the importance of treating patients with respect and dignity, little is known about what constitutes treatment in this regard. The intensive care unit (ICU) is a unique setting that can pose specific threats to treatment with respect and dignity owing to the critical state of patients, stress and anxiety amongst patients and their family members, and the highly technical nature of the environment. In attempt to understand various stakeholders’ perspectives of treatment with respect (...) and dignity, patients and family members were interviewed, a wide range of health care professionals participated in focus groups, and third party observers took field notes of interactions in the ICU. This paper compares and contrasts the data that were generated using these different methods. Triangulating the data in this way contributes to a more complete and nuanced understanding of treatment with respect and dignity in the ICU. (shrink)

In this paper, we explore the desires that play a role at the palliative stage and relate them to various approaches to patient autonomy. What attitude can physicians and other caregivers take to the desires of patients at the palliative stage? We examine this question by introducing five physicians who are consulted by Jackie, an imaginary patient with metastatic lung carcinoma. By combining the models of the physician-patient relationship developed by Emanuel and Emanuel (1992) and the Hellenistic approaches to desires (...) analyzed by Nussbaum (1994), five different ways of dealing with desires in the context of palliative care are sketched. The story of Jackie shows that desires are to a certain extent responsive to reasoning. In the palliative process, that can be a reason to devote attention to the desires of patients and caregivers and to determine which desires need to be fulfilled, which are less important, and how they are linked to emotions the patient has. (shrink)

Signaling complexes and networks are being intensely studied in an attempt to discover pathways that are amenable to therapeutic intervention. A challenge in this search is to understand the effect that the modulation of a target will have on the overall function of a cell and its surrounding neighbors. Protein‐interaction mapping reveals relationships between proteins and their impact on cellular processes and is being used more widely in our understanding of disease mechanisms and their treatment. The review discusses (...) challenges and breakthroughs in this new and evolving area and its impact on medicine. BioEssays 27:958–969, 2005. © 2005 Wiley Periodicals, Inc. (shrink)

My dissertation asks how we affect conversational context and how it affects us when we participate in any conversation—including philosophical conversations. Chapter 1 argues that speakers make pragmatic presuppositions when they use proper names. I appeal to these presuppositions in giving a treatment of Frege’s puzzle that is consistent with the claim that coreferential proper names have the same semantic value. I outline an explanation of the way presupposition carrying expressions in general behave in belief ascriptions, and suggest that (...) substitutivity failure is a special case of this behavior. Chapter 2 develops a compositional probabilistic semantics for the language of subjective uncertainty, including epistemic adjectives scoped under quantifiers. I argue that we should distinguish sharply between the effects that epistemically hedged statements have on conversational context, and the effects that they have on belief states. I also suggest that epistemically hedged statements are a kind of doxastic advice, and explain how this hypothesis illuminates some otherwise puzzling phenomena. Chapter 3 argues that ordinary causal talk is deeply sensitive to conversational context. The principle that I formulate to characterize that context sensitivity explains at least some of the oddness of ‘systematic causal overdetermination,’ and explains why some putative overgenerated causes are never felicitously counted, in conversation, as causes. But the principle also makes metaphysical theorizing about causation rather indirectly constrained by ordinary language judgments. (shrink)

IntroductionTranscranial magnetic stimulation is a consolidated procedure for the treatment of depression, with several meta-analyses demonstrating its efficacy. Theta-burst stimulation is a modification of TMS with similar efficacy and shorter session duration. The geriatric population has many comorbidities and a high prevalence of depression, but few clinical trials are conducted specifically for this age group. TBS could be an option in this population, offering the advantages of few side effects and no pharmacological interactions. Therefore, our aim is to investigate (...) the efficacy of TBS in geriatric depression.Clinical trial registration[https://clinicaltrials.gov/ct2/], identifier [NCT04842929]. (shrink)

Although the field of psychiatry has witnessed the proliferation of studies on Gene x Environment (GxE) interactions, still limited is the knowledge we possess of GxE interactions regarding developmental disorders. In this perspective paper, we discuss why GxE interaction studies are needed to broaden our knowledge of developmental disorders. We also discuss the different roles of hazardous versus self-generated environmental factors and how these types of factors may differentially engage with an individual’s genetic background in predicting a resulting phenotype. (...) Then, we present exemplar studies that highlight the role of GxE in predicting atypical developmental trajectories as well as provide insight regarding treatment outcomes. Supported by these examples, we explicate the need to move beyond merely examining statistical interactions between genes and the environment, and to investigate specific genetic susceptibility and environmental contexts that drive developmental disorders. We propose that further parsing of genetic and environmental components is required to fully understand the unique contribution of each factor to the etiology of developmental disorders. Finally, with a greater appreciation of the complexities of GxE interaction, this discussion will converge upon the potential implications for clinical and translational research. (shrink)

Based on therapeutic meetings with individuals who have experienced sexual violence and abuse, the challenge is how do we help these couples to establish sexual relationships on their own terms, without interference of defence or coping strategies they have used to protect themselves against the overwhelming experiences of violence or abuse in the past? This article will focus on therapeutic work with such couples and how to interact with them and support their efforts to establish satisfying sexual relationships, based on (...) sexological experience as well as experience from work with traumatisation. The basis for our treatment is a modified version of William Masters and Virginia Johnson’s approach. The technique of sensate focus is central, modified by trauma theory, including the understanding of dissociation, and the need to integrate memories from different levels: somatic, emotional, and cognitive. The traumatised client needs special attention to the experiences of predictability and safety and respect due to their history of being transgressed against. The therapists must be aware of the issue of dissociation; different dissociated inner parts can play different roles in the interaction between client and therapist. While couples therapy is a necessary frame for this therapy, the therapist often needs to work with issues unique to each individual. Each partner must be able to identify their own responses and their own sexual needs and preferences. It may therefore be valuable to have a co-therapist. The central goal is for the clients to identify responses to stimulation as a here and now experience in a setting that feels safe and welcome. (shrink)

The Many-Interacting-Worlds (MIW) approach to a quantum theory without wave functions proposed in [8] leads naturally to numerical integrators of the Schrödinger equation on comoving grids. As yet, little is known about concrete MIW models for more than one spatial dimension and/or more than one particle. In honour of Detlef Dürr, we report on a further development of the MIW approach to treat arbitrary degrees of freedom and provide a numerical proof of concept for ground states in 2d. The latter (...) is part of a systematic numerical study [22] that includes also 1d ground and excited states. With this step towards the treatment of higher degrees of freedom we hope to stimulate their further study. (shrink)

This article features the contributions of Fichte and Schopenhauer to a philosophical account of action against the background of Kant's earlier and influential treatment of the topic. The article first presents Kant's pertinent contributions in the areas of general epistemology and metaphysics, general practical philosophy, the philosophy of law and ethic. Then the focus is on Fichte's further original work on the issue of action in those same areas. Finally, the article turns to Schopenhauer's radical revision of the Kantian (...) and Fichtean affirmative accounts of acting and willing through the correlated introduction of the irrational will, the self-negated will and ethical inaction. (shrink)

Whenever the legitimacy of a new or ethically contentious medical intervention is considered, a range of influences will determine whether the treatment becomes accepted as lawful medical treatment. The development and introduction of abortion, organ donation, gender reassignment, and non-therapeutic cosmetic surgery have, for example, all raised ethical, legal, and clinical issues. This book examines the various factors that legitimatise a medical procedure. Bringing together a range of internationally and nationally recognised academics from law, philosophy, medicine, health, economics, (...) and sociology, the book explores the notion of a treatment, practice, or procedure being proper medical treatment, and considers the range of diverse factors which might influence the acceptance of a particular procedure as appropriate in the medical context. Contributors address such issues as clinical judgement and professional autonomy, the role of public interest, and the influence of resource allocation in decision-making. In doing so, the book explores how the law, the medical profession, and the public interact in determining whether a new or ethically contentious procedure should be regarded as legitimate. This book will be of interest and use to researchers and students of bioethics, medical law, criminal law, and the sociology of medicine. (shrink)

This paper challenges the exclusion of patients from epistemic practices in psychiatry by examining the creation and revision processes of the Diagnostic and Statistical Manual of Mental Disorders (DSM), a document produced by the American Psychiatric Association that identifies the properties of mental disorders and thereby guides research, diagnosis, treatment, and various administrative tasks. It argues there are epistemic—rather than exclusively social/political—reasons for including patients in the DSM revision process. Individuals with mental disorders are indispensable resources to enhance psychiatric (...) epistemology, especially in the context of the crisis, controversy, and uncertainty surrounding mental health research and treatment. (shrink)

Although the role of fairness in tax compliance has been of increasing interest among the academic and professional tax communities, very little is known about the role of interactional fairness. Interactional fairness refers to the quality of the treatment provided to individuals from authority figures, such as tax authority representatives. We conduct an experiment using US taxpayers to examine the role of interactional fairness on tax compliance intentions, and how detection influences this relation. Taxpayers’ detection salience reflects their perceptions (...) that they will be audited by the tax authority. Using insights from conditional cooperation theory, we predict and find that detection moderates the relation between interactional fairness and tax compliance intentions, such that the effect of interactional fairness on tax compliance intentions diminishes with higher detection. We discuss the implications of our results for tax policy. (shrink)

Multimorbidity, the presence of multiple health conditions that must be addressed, is a particularly difficult situation in patient management raising issues such as the use of multiple drugs and drug-disease interactions. Clinical Guidelines are evidence-based statements which provide recommendations for specific health conditions but are unfit for the management of multiple co-occurring health situations. To leverage these evidence-based documents, it becomes necessary to combine them. In this paper, using a case example, we explore the use of argumentation schemes to reason (...) and combine evidence-based recommendations from clinical guidelines, expected effects, conflicts stemming from said recommendations, and preferences regarding treatment goals. We compare the results of reasoning using the schemes for practical reasoning and argument from negative consequences in the Carneades Argumentation System with those of ASPIC-G, an extension of the artificial intelligence system ASPIC+. (shrink)

On many occasions, care givers are faced with problems in which “drastic” types of treatment seem clearly inappropriate but “lesser” interventions still appear to be advisable, if not indeed mandatory. In the hospital setting, examples are frequent: the demented elderly patient, still very much capable of brief social interactions and still able to enjoy at least limited life, who although clearly not a candidate for coronary bypass surgery is, nevertheless, a patient in whom an intercurrent pneumonia deserves treatment; (...) the severely retarded youngster in whom appendectomy seems clearly warranted but for whom long-term dialysis seems ill-advised. The examples are legion, and their variety defies an easy, stereotypical solution. Why, one may ask, is the treatment of intercurrent pneumonia or operating on an acute appendix “clearly indicated” while coronary bypass and long-term dialysis “clearly” are not? The reactions of care givers in the past have often consisted of attempts to give half-hearted treatment or to treat fully even against their better judgment. The lack of conceptual guidelines that might help sort out such problems has inevitably led either to an inflexible absolutism in which all possible treatment to sustain life or no treatment at all is given or has resulted in a pathetic attempt to act but act minimally with the hope that such actions will be ineffective. (shrink)

The paper looks in detail at patients that were treated at one of the most discussed companies operating in the field of untried stem cell treatments, Beike Biotech of Shenzhen, China. Our data show that patients who had been treated at Beike Biotech view themselves as proactively pursuing treatment choices that are not available in their home countries. These patients typically come from a broad variety of countries: China, the United Kingdom, the United States, South Africa and Australia. Among (...) the patients we interviewed there seemed to be both an awareness of the general risks involved in such experimental treatments and a readiness to accept those risks weighed against the possible benefits. We interpret this evidence as possibly reflecting the emergence of risk-taking patients as ‘consumers’ of medical options as well as the drive of patients to seek treatment options in the global arena, rather than being hindered by the ethical and regulatory constraints of their home countries. Further, we found that these patients tend to operate in more or less stable networks and groups in which they interact and cooperate closely and develop opinions and assessments of available treatment options for their ailments. These patients also perform a multiple role as patients, research subjects, and research funders because they are required to pay their way into treatment and research activities. This new social dynamics of patienthood has important implications for the ethical governance of stem cell treatments. (shrink)

In this paper, I examine the scope and limits of Brian Barry’s uniform treatment approach to cultural differences through a critical assessment of its two main arguments. The first maintains that under a regime of institutions serving legitimate public purposes, equal opportunity is an objective state of affairs, and religious or cultural maladjustments to laws and public policies are morally irrelevant to the issue of equal opportunity. The other maintains that unlike physical disabilities, religious and cultural affiliations are the (...) result not of morally arbitrary factors over which one has no control but of life choices for which people must assume responsibility. To the first argument, I respond that equal opportunity is best viewed as an interactive phenomenon encompassing subjective and objective components and that a deliberative approach to cultural claims is more likely than Barry’s uniform approach does to grant religious and cultural minorities equal opportunities and equal treatment. To the second argument, I respond that, even if they arise out of the life choices made by people, religious conducts and cultural practices deserve to be accommodated through law exemption because it is sometimes the only way our liberal democracies can show respect for citizens as ethical subjects. (shrink)

Recent developments in pattern analysis research have made this methodology suitable for the study of the processes that are set in motion in psychological interventions. Outcome research, based on the comparison between clinical results from treatment and control groups, has leveraged our empirical knowledge about the efficacy of psychological interventions. However, these methods of research are not precise enough for the analysis of these processes. On the contrary, pattern analysis could be a powerful tool to study moment-to-moment interactions typical (...) of psychological interventions. This is methodology is relevant because clinical psychology is experiencing a paradigm shift from a protocol for syndrome perspective to a principle-based and person-centered intervention. This evidence-based, theory-grounded, and process-oriented paradigm of clinical intervention needs new research methods to thrive. The analysis of the therapeutic relationship built into the verbal interaction between the clinician and the client is one of the cornerstones of this new era of research. So, the purpose of this article is three-fold: to discuss the role of the verbal interaction pattern analysis in the clinical context to the development of the principle-based clinical psychology, to analyze the patterns of verbal interaction in a clinical case, and to compare the results using two different methods. To reach these purposes, using the observational methodology, we have coded the verbal interaction of 16 clinical sessions with a person diagnosed with a borderline personality disorder. We have analyzed the data using sequential analysis and pattern recognition algorithms. We have been able to detect typical patterns during different phases of psychological intervention. Finally, the conceptual, methodological, and empirical implications of this study will be discussed within the realms of pattern analysis research and principle-based clinical psychology. (shrink)

Research has shown that the strongest reactions to organizational injustice occur when an employee perceives both unfair outcomes (distributive injustice) and unfair and unethical procedures and treatment. Utilizing the Referent Cognitions Theory (RCT) framework, this study investigates how a form of distributive injustice, psychological contract breach, along with procedural and interactional injustice influences employees'' negative attitudes and behaviors. More specifically, the interactional effects of these forms of injustices should be notably greater than those exhibited when an employee of the (...) organization, following a contract breach, perceives both fair and ethical processes and treatment. Three hundred and twenty-two employees from a variety of organizational settings completed measures of contract breach, procedural injustice, interactional injustice, and negative affect toward the organization. Their respective supervisors completed a measure of deviant work behaviors. Results revealed a three-way interaction between contract breach, procedural injustice, and interactional injustice on negative affect and deviant work behavior. The nature of the interaction was further investigated through simple slope analyses. Consistent with the study''s propositions, deviant work behavior was higher following a contract breach when both procedural and interactional injustice were high. However, the association between negative affect and breach was high when both forms of injustices were high and when only interactional injustice was high. Study contributions and limitations as well as theoretical and ethical implications are discussed. (shrink)

Since Montague’s work it is well known that treating a single modality as a predicate may lead to paradox. In their paper “No Future”, Horsten and Leitgeb show that if the two temporal modalities are treated as predicates paradox might arise as well. In our paper we investigate whether paradoxes of multiple modalities, such as the No Future paradox, are genuinely new paradoxes or whether they “reduce” to the paradoxes of single modalities. In order to address this question we develop (...) a notion of reducibility based on a version of Smoryński Diagonalized Operator Logic. We show that there are reducible multimodal paradoxes as well as irreducible paradoxes of interaction. In particular, we show the No Future paradox to be an irreducible paradox according to our notion of reducibility. (shrink)

Although the role of fairness in tax compliance has been of increasing interest among the academic and professional tax communities, very little is known about the role of interactional fairness. Interactional fairness refers to the quality of the treatment provided to individuals from authority figures, such as tax authority representatives. We conduct an experiment using US taxpayers to examine the role of interactional fairness on tax compliance intentions, and how detection influences this relation. Taxpayers’ detection salience reflects their perceptions (...) that they will be audited by the tax authority. Using insights from conditional cooperation theory, we predict and find that detection moderates the relation between interactional fairness and tax compliance intentions, such that the effect of interactional fairness on tax compliance intentions diminishes with higher detection. We discuss the implications of our results for tax policy. (shrink)

Mentalizing - the ability to understand oneself and others by inferring the mental states that lie behind overt behavior - develops during childhood within the context of a secure attachment relationship. It is crucial to self-regulation and constructive, intimate relationships. Failure to retain mentalizing, particularly in the midst of emotional interactions, is a core problem in borderline personality disorder and results in severe emotional fluctuations, impulsivity, and vulnerability to interpersonal and social interactions. Mentalization-based treatment for borderline personality disorder is (...) a 'How to Do It' book outlining a clinically proven treatment for Borderline Personality Disorder. Containing illustrative clinical examples, it details precisely how to develop and implement treatment and is a companion to the highly successful book Psychotherapy for Borderline Personality Disorder - mentalization based treatment. This practical guide explains how to treat borderline patients by helping them develop a more robust mentalizing capacity within the context of an attachment relationship. It provides the practitioner with everything they need to know about how to practise mentalizing treatment in day patient and out-patient settings. Enough theory is provided to orientate the clinician and there is step-by-step practical advice on the assessment of mentalizing and interpersonal relationships, how to structure treatment, the use of basic mentalizing interventions and how to apply them, as well as information on what not to do. In addition, it includes a check list to be used in the assessment of mentalizing and a self-rating exercise for practitioners to evaluate their adherence to mentalizing. (shrink)

Heterogeneous treatment effects represent a major issue for medicine as they undermine reliable inference and clinical decision-making. To overcome the issue, the current vision of precision and personalized medicine acknowledges the need to control individual variability in response to treatment. In this paper, we argue that gene-treatment-environment interactions (G × T × E) undermine inferences about individual treatment effects from the results of both genomics-based methodologies—such as genome-wide association studies (GWAS) and genome-wide interaction studies (GWIS)—and (...) randomized controlled trials (RCTs). Then, we argue that N-of-1 trials can be a solution to overcome difficulties in handling individual variability in treatment response. Although this type of trial has been suggested as a promising strategy to assess individual treatment effects, it nonetheless has limitations that limit its use in everyday clinical practice. We analyze the existing variability within the designs of N-of-1 trials in terms of a continuum where each design prioritizes epistemic and pragmatic considerations. We then support wider use of the designs located at the pragmatic end of the explanatory-pragmatic continuum. (shrink)

Assertive community treatment (ACT) is a widely propagated team approach to community mental health care that ‘assertively’ engages a subgroup of individuals with severe mental illness who continuously disengage from mental health services. It involves a number of interested parties – including clients, carers, clinicians and managers. Each operates according to perceived ethical principles related to their values, mores and principles. ACT condenses a dilemma that is common in psychiatry. ACT proffers social control whilst simultaneously holding therapeutic aspiration. The (...) clients’ perspective of this dilemma was studied in interviews with 12 clients using the ‘grounded theory’ approach. Results suggest that clients’ disengagement is as much a historical and cultural phenomenon as a result of lack of insight. Many clients had experienced rejection of early help–seeking behaviour and all had been subject to coercive interventions. These coercive interventions were experienced as an attack on identity. All felt that their voice had not been listened to in previous interactions with psychiatric services. Consequentially the clients had an increased level of arousal around issues of power, which needs to be incorporated when examining the ethics of community psychiatry. Traditional notions of the difference between persuasion and coercion – for example – may need to be adapted for this client group. Results are compared with the provider perspective. We conclude that the perspectives differ on two key dimensions. Such an empirical approach to examining psychiatric ethics may ensure that we incorporate the subjectivities of various interested parties in the clinical decision–making process. (shrink)

Medical records are documents of tremendous social importance. They have been the subject of much medical and sociological research, in particular regarding validity, accessibility and readability. This paper uses Conversation Analysis to add an aspect to the understanding of medical records that has been missing so far, namely how medical records are produced as interactional accomplishments; specifically, how hospital staff members during meetings conversationally negotiate and reach conclusions, treatment recommendations, and other types of consequential decisions. The process involves four (...) steps: assessing patients, interpreting implications, drawing conclusions, and dictating conclusions on tape. The key finding is that participants throughout the process orient towards a need for consensus, whilst at the same time acknowledging the doctors’ interactional leading roles. This insight can enhance our understanding of medical records in hospital settings as constructed and negotiated realities. (shrink)

Research on medical interactions shows how the discursive construction of the clinical case impacts diagnostic reasoning and treatment recommendations. Drawing on an ethnographic study in an intensive care unit, we illustrate how this process is at play in a ward that adopts an extreme, guideline-divergent policy as to the use of antibiotics. The article focuses on how physicians assemble the case as ‘treatable’ or ‘not yet treatable’, and how in doing so they ‘talk into being’ two contrastive policies on (...) antibiotics and position themselves toward the one adopted in the ward. The analysis identifies the discursive resources displayed by physicians to both project an infectious disease diagnosis and resist this treatment-implicative trajectory. We argue that the physicians’ contentious discursive construction of the case has crucial consequences in the way the ward’s extreme policy is jointly accomplished as a highly reflexive process sensitive to the contingencies of any particular case. (shrink)

Little is known about employee reactions in the form of un/ethical behavior to perceived acts of unfairness toward their peers perpetrated by the supervisor. Based on prior work suggesting that third parties also make fairness judgments and respond to the way employees are treated, this study first suggests that perceptions of interactional justice for peers (IJP) lead employees to two different responses to injustice at work: deviant workplace behaviors (DWBs) and organizational citizenship behaviors (OCBs). Second, based on prior literature pointing (...) to supervisors as among the most important sources of moral guidance at work, a mediating role is proposed for ethical leadership. The article suggests that supervisors who inflict acts of injustice on staff will be perceived as unethical leaders, and that these perceptions would explain why employees react to IJP in the form of deviance (DWBs) and citizenship (OCBs). Data were collected from 204 hotel employees. Results of structural equation modeling demonstrate that DWBs and OCBs are substantive reactions to IJP, whereas ethical leadership significantly mediates reactions in the form of DWBs and OCBs. Behavioral ethics and managerial implications are discussed. (shrink)

Effective doctor patient relationships are predicated on doctors' relational engagement and affective/holistic communication with the patients. On the contrary, the contemporary healthcare and patient-clinician communication are at odds with the desirable professional goals, often resulting in dehumanization and demoralization of patients. Besides denigrating the moral agency of a patient such apathetic interactions and unprofessional approach also affect the treatment and well-being of the sufferer. Foregrounding multifaceted doctor-patient relationships, graphic pathographies are a significant cultural resource which recreate the embodied moment (...) of clinical encounters as they also lay bare qualitative tensions between patient' illness experience with doctor's professional understanding of the same. Taking these cues, the present article drawing theoretical postulates of Rita Charon, Deborah Lupton, and Havi Carel close reads Peter Dunlap-Shohl's My Degeneration: A Journey Through Parkinson's, Brian Fies' Mom's Cancer, and Stan Mack's Janet & Me: An Illustrated Story of Love and Loss to investigate the nature of doctor-patient relationship vis-à-vis communication and the implications of bad doctoring/communicative practices on patient identity and emotions. Furthermore, the article also examines the aesthetic and functional role of comics in bringing into relief the graphically mediated doctor-patient relationship. (shrink)

This article is an introduction to the special issue on interactions between analytic and Islamic philosophy/theology. Islamic philosophy and theology have historically demonstrated the aptitude and scope in being able to engage with philosophical rationalist traditions beyond classical Islamic civilisation. Articles in this special issue of the European Journal of Analytic Philosophy provide a new and fresh outlook of the relation and influences between Islamic philosophical and theological traditions and the Western (analytic) philosophical tradition.

BackgroundMild cognitive impairment is a common neurological disorder. Moxibustion has been shown to be effective in treating MCI, but its therapeutic mechanisms still remain unclear. This study mainly aimed to investigate the modulation effect of moxibustion treatment for patients with MCI by functional magnetic resonance imaging.MethodsA total of 47 patients with MCI and 30 healthy controls participated in resting-state fMRI imaging scans. Patients with MCI were randomly divided into true moxibustion group and sham moxibustion group. The degree centrality approach (...) was applied to distinguish altered brain functions. Correlation analysis was then performed to examine the relationships between the neuroimaging findings and clinical symptoms.ResultsCompared with HCs, patients with MCI mainly showed decreased DC in the left middle frontal cortex and bilateral middle cingulate cortex. After moxibustion treatment, the SHAM group had no significant DC findings, while TRUE group mainly showed significant increased DC in the bilateral MFC and MCC, as well as decreased DC in the left middle occipital cortex. Repeated measures analysis of variance showed significant interactions between the two groups of patients with MCI. In addition, the higher Mini-Mental State Examination score was significantly positively correlated with increased DC in the right MFC and left MCC after moxibustion treatment.ConclusionOur findings demonstrate that the potential value of moxibustion treatment on MCI, which adds new insights into the popular view that moxibustion treatment may slow cognitive decline in patients with MCI. (shrink)

According to Information-Motivation-Behavioural Skills model, accurate Information, strong Motivation and adequate Behavioural skills are prerequisites of treatment adherence. This model has been verified among chronically ills patients, usually suffering from one particular disorder. No studies report how the model fits data from a more diverse group. The aim of the study was to analyze adherence and its barriers in a group of three hundred patients suffering from various, common chronic disorders. They filled out IMB and Adherence Questionnaire. Information and (...) Motivation correlated moderately. Behavioural Skills was the strongest predictor of adherence. An additional relationship was found: Information and Motivation interacted and the role of either of these dimensions vanished if the indices of the other were high enough. The relationships between IMB dimensions and adherence were confirmed in a varied clinical sample. Behavioural skills must be considered when working with non-adherent patients, as they are the strongest predictor of adherence. Other interventions may be limited to either Information or Motivation only if there is a chance of raising one of them to extreme levels. This may be useful with special cases, when increasing both is problematic. (shrink)

This paper critically examines Hume’s argument against the knowledge/existence of substantival mind. This denial is rooted in his epistemology which includes a theory of how complex ideas which lack corresponding impressions are manufactured by the imagination, in conjunction with the memory, on the basis of three relations among impressions: resemblance, continuity and constant conjunction. The crux of my critique consists in pointing out that these relations are such that only an enduring, unified agent could interact with them in the way (...) Hume describes. I note that Hume attempts to provide such an agent by invoking the activities of imagination and memory, but that it is unclear where these belong in his system. After discussing the relevant possibilities, I conclude that there is no category within the limits of his system that can accommodate the faculties and allow them to do the work Hume assigned to them. I then note that Hume’s rejection of substantival mind rests upon the assumption that something like substantival mind exists; for the action of the latter is required for the proper functioning of the process of fabrication which creates the fictitious notion of substantival mind. My concluding argument is that if the existence of substantival mind is implicit in Hume’s argument against substantival mind, then his argument resembles an indirect proof, and ought to be considered as evidence for, rather than against, the existence of substantival mind. (shrink)

Background In nursing homes, residents’ relatives represent important sources of support for nurses. However, in the heightened stress of emergency situations, interaction between nurses and relatives can raise ethical challenges. Research objectives The present analysis aimed at elaborating a typology of nurses’ experience of ethical support and challenges in their interaction with relatives in emergency situations. Research design Thirty-three semi-structured interviews and six focus groups were conducted with nurses from different nursing homes in Germany. Data were analysed according (...) to Mayring’s method of qualitative content analysis. Participants and research context Participants were licensed nurses working in nursing homes. Ethical considerations Ethical approval was granted by Ostfalia University of Applied Sciences (02.07.2020) and the Ethics Committee of Hannover Medical School (Nr. 8866_BO_K_2020; 27.01.2020). Interviewees were anonymised and focus group were pseudonymised during transcription. All participants provided written consent. Findings/results In emergency situations, relatives can represent important sources of support for nurses. However, they may also give rise to different challenges, relating to four ethical conflicts: (1) the challenge of meeting the information needs of relatives while providing appropriate care to all residents; (2) the challenge of managing relatives’ demands for hospitalisation when hospitalisation is not deemed necessary by nurses; (3) the challenge of managing relatives’ demands for lifesaving treatment when such treatment contradicts the will of the resident; and (4) the challenge of attempting to initiate hospitalisation when relatives oppose this course of action. Several external factors make these conflicts especially challenging for nurses: fear of legal consequences, a low staffing ratio, and a lack of qualified nursing staff. Conclusions Conflict between nurses and relatives typically revolves around hospitalisation and the initiation of lifesaving treatment. Whether nurses perceive interaction with relatives as supportive or conflictual essentially depends on the quality of the relationship, which may be negatively influenced by a number of external factors. (shrink)

The present study aimed to examine whether the applied practice of cameras in courtrooms plays a positive role in public confidence in legal authorities and how such impact may occur from the perspectives of the Group Value Model and the surrogacy effect. A convenience sample of 170 college students participated in this experiment. The control group read the written judgment of a civil case published online while the experimental group read the same judgment and watched the court trial video of (...) that case. The overarching mediation model confirmed that there was a significant and indirect influence of video watching on confidence in justice in general. The key underlying mechanisms of this impact were the positive perception of the interpersonal treatment by the judge as well as the perceived fairness of the procedure. This study contributes to the currently limited research examining whether and, if so, how courtroom broadcasting promotes public trust through obtaining empirical evidence. It also expands the application of the Group Value Model to a vicarious interaction setting and provides evidence of the surrogacy effect in a civil legal context. (shrink)

A strength of Jablonka & Lamb's (J&L's) book lies in its accessible as well as thorough treatment of genetic and epigenetic inheritance. The authors also provide a stimulating framework integrating evolutionary research across disciplines. A weakness is its unsystematic treatment of the interaction between behavioral and symbolic inheritance, particularly in their discussion of language.