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The nuclear bomb: a concretization and erotization of power.

This article contends that the nuclear bomb is the concrete representation of an archaic idealizing system. It uses concepts published by Atwood and Stolorow (1984) to demonstrate how the bomb is no protection at all to our national defense; rather it compensates for empty or poorly developed psychological structure and function of individual and group. The continued proliferation of the bomb--some 70,000 at last count--despite the knowledge that just a few can obliterate our world is testimonial to the need for a concrete and visible mound of weapons. Since this need can never be satisfied by these means, there can never be enough bombs to be sufficient. The article extends the concept of this faulty or absent development of psychological structure to the weakening or loss of primary affiliative bonding between individuals and groups, which has psychohistorical roots. Three historical developments intertwine and reinforce one another: (1) the isolation of national defense to weapons and war; (2) the evolution of a modern science based on a duality between body (affects) and mind (cognition) and contributing to sexual polarization, in which masculinity has been identified with valued objectivity and femininity has been identified with devalued affiliative affects; (3) the equation of sex and aggression with power and their use as substitutes for derailed development of affiliative needs and functions.

Erotica↗

[Communication in care: a fundamental task in nursing].

The research debates the communication as basic instrument of the attention, articulated to the dynamic of the care and of the attention in the hospital. Interviews had been made, participant observation and consult to promptuaries. It was applied dense description and thematic analysis. It was identified diverse forms of communication: verbal and nonverbal. It was stood out the form as the professional approached and communicated with the customer, printing more or little attention and affection. The interaction in the attention emerged of the meeting and colloquies among the professionals and customers, integrating them to the attention. The act of talk is basic in the attention. Either of technician or ludic content, the colloquy implies in communication, that holds interaction, language, gestures and cognition. From there its importance for the nursing, art and science of the attention.

Communication↗

Rehabilitation of the head-injured child: basic research and new technology.

The view that brain damage in children is less impairing than equivalent damage in adults is no longer acceptable. However, it is acknowledged that recovery following brain damage, when it does occur, owes much to the plasticity of the brain and that the young brain displays greater plasticity than the mature brain. To maximize brain damage recovery in children we need to focus both on what is known about brain plasticity and how to influence it. Research on environmental enrichment in rats has told us that enforced interaction with a complex environment can both stimulate anatomical and biochemical plasticity and ameliorate some of the behavioural consequences of brain damage. The view that environmental interaction has rehabilitative value also accords with clinical experience. However, the sensory, motor and cognitive consequences of brain damage often conspire to make environmental interaction difficult. One potential solution lies in using computers to generate virtual environments tailored to the precise sensory and motor capacities of the brain-injured child. In this way children may be enabled to benefit from environmental interaction whatever their level of disability. The use of Virtual Reality (VR) in the context of rehabilitation is discussed and relevant work reviewed.

Adult↗

Use your words!

"Use your words!" is a phrase admonishing preschoolers to divert their action-proneness to thought and language. Freud's injunction against acting out had a similar aim, placing control over drives in the domain of "inner language." The twenty-first-century psychoanalyst continues to employ models that depend on mentalization viewed from two angles-neural inhibition and social discourse. Psychoanalysts bolster their position by borrowing from the basic scientific work in each area. The recent focus on enactments, intersubjectivity, and social constructivism is reconsidered from an historical vantage point, as is the work that seeks to reconcile recent findings in neuroimaging and cognitive neuroscience. Freud's vision included a holistic hope that a comprehensive science of human beings might be achieved by understanding derived from biological inquiry and the artifacts of social and cultural narratives. The author's experience in both domains is recounted, and a new reconciliation of disparate approaches is offered in linguistic complementarity.

Cognition↗

Toward a world consensus on prevention of schizophrenia.

Screening for preschizophrenia in the general population with the aim of preventing transition to full-blown illness is an epidemiological impossibility because a rare disease cannot be predicted. The lack of specificity resulting in abundance of false-positives can be remedied in part by using much more restrictive screening criteria that combine several indicators of risk for transition to schizophrenia. Raising the specificity (reducing the false-positives), however, can only be done at the expense of sensitivity (increasing the false-negatives). The most commonly used strategy to raise specificity is the sample enrichment strategy. This involves the creation of samples enriched with schizophrenia risk by selectively filtering at-risk people out over a range of consecutive referral processes starting in the general population, through to general practioners, mental health services, and the early detection clinic. However, improvements in specificity obtained by the sample enrichment strategy should not be attributed to the use of some predictive instrument that supposedly identifies high-risk individuals. The epidemiologically and ethically most viable way for screening and early detection is to selectively increase the permeability of the filters on the pathway to mental health care. This will occasion samples of help-seekers enriched with schizophrenia risk at the level of mental health services (thus reducing false-positives), while at the same time making an attempt to "attract" as many detectable schizophrenia prodromes as possible through the filters along the pathway to mental health care (thus reducing false-negatives). Early psychosis research has yielded some useful suggestions in that it is becoming increasingly clear that it is not just psychosis itself, but rather the clinical context of the psychotic experience that determines risk for transition to schizophrenia. Thus, risk for transition to full-blown psychotic disorder is to a large degree determined by size of psychosis "load," comorbid distress and depression, cannabis use, cognitive ability, and subjective reports of impairment and coping. Making a diagnosis of psychotic disorder is not an exact science: it involves an arbitrary cutoff imposed on dimensional variation of psychopathology and need for care over time. Gaining insight into the cognitive and biological factors that drive the dimensional variation, including therapeutic interventions, is arguably more useful than sterile dichotomous prediction models.

Global Health↗

Effects of age on auditory and cognitive processing: implications for hearing aid fitting and audiologic rehabilitation.

Recent advances in research and clinical practice concerning aging and auditory communication have been driven by questions about age-related differences in peripheral hearing, central auditory processing, and cognitive processing. A "site-of-lesion'' view based on anatomic levels inspired research to test competing hypotheses about the contributions of changes at these three levels of the nervous system. A "processing'' view based on psychologic functions inspired research to test alternative hypotheses about how lower-level sensory processes and higher-level cognitive processes interact. In the present paper, we suggest that these two views can begin to be unified following the example set by the cognitive neuroscience of aging. The early pioneers of audiology anticipated such a unified view, but today, advances in science and technology make it both possible and necessary. Specifically, we argue that a synthesis of new knowledge concerning the functional neuroscience of auditory cognition is necessary to inform the design and fitting of digital signal processing in "intelligent'' hearing devices, as well as to inform best practices for resituating hearing aid fitting in a broader context of audiologic rehabilitation. Long-standing approaches to rehabilitative audiology should be revitalized to emphasize the important role that training and therapy play in promoting compensatory brain reorganization as older adults acclimatize to new technologies. The purpose of the present paper is to provide an integrated framework for understanding how auditory and cognitive processing interact when older adults listen, comprehend, and communicate in realistic situations, to review relevant models and findings, and to suggest how new knowledge about age-related changes in audition and cognition may influence future developments in hearing aid fitting and audiologic rehabilitation.

Aged↗

A critique of compromise: beyond the methods debate.

One resolution to the debate about whether quantitative or qualitative methods are appropriate or adequate for nursing's research concerns has been to argue that either or both are legitimate, depending on the research problem. This article suggests that the overt debate is a manifestation of more fundamental differences over ontologies, epistemologies, values, and intentions, and that the compromise solutions mask basic issues that nursing needs to address as nursing science is advanced. Several of the hidden choices in the debate about methods are made explicit, and their implications for nursing practice are identified.

Cognition↗

Chemotherapy and cognition: effects, potential mechanisms, and management.

The development of novel chemotherapeutic agents and advances in treatment technique have improved survival for patients diagnosed with some forms of cancer, but treatments are not always site specific and may place normal tissues at risk. The central nervous system (CNS) is susceptible to treatment effects and complaints of memory loss and generalized cognitive decline are common among cancer patients. Despite the frequency of subjective patient complaints, studies evaluating the cognitive abilities of patients have inconsistently reported chemotherapy-related declines. On careful review of the literature, discrepant findings across studies (some documenting chemotherapy-related cognitive declines and others failing to detect such changes) may be attributed to differences in methodology. Most studies have been retrospective in design, omit pretreatment assessment of function, use small or heterogeneous samples, use inappropriate measures to assess cognition, and fail to incorporate control subjects. Though rare to date, prospective, randomized, longitudinal studies that incorporate pretreatment comprehensive neuropsychological assessment are necessary to define the severity and pattern of treatment-related change. Building on a foundation of solid science, future studies may identify subgroups of patients susceptible to significant chemotherapy-related cognitive decline. Once these groups are identified and the mechanisms underlying the decline are elucidated, attention may be turned to the development of treatments that may optimize cognitive function and improve patient quality of life.

Antineoplastic Agents↗

Rationality.

This chapter reviews selected findings in research on reasoning, judgment, and choice and considers the systematic ways in which people violate basic requirements of the corresponding normative analyses. Recent objections to the empirical findings are then considered; these objections question the findings' relevance to assumptions about rationality. These objections address the adequacy of the tasks used in the aforementioned research and the appropriateness of the critical interpretation of participants' responses, as well as the justifiability of some of the theoretical assumptions made by experimenters. The objections are each found not to seriously impinge on the general conclusion that people often violate tenets of rationality in inadvisable ways. In the process, relevant psychological constructs, ranging from cognitive ability and need for cognition, to dual process theories and the role of incentives, are discussed. It is proposed that the rationality critique is compelling and rightfully gaining influence in the social sciences in general.

Affect↗

Technology and Society.

Technology has had a great impact on changes in life-style during the past. Urgent requirements concerning alimentation, health care, traffic and communication have been met by means of technology. The physical, sensory and intelligent strength of man have been multiplied by the utilization of natural resources, and the average lifetime has been increased considerably. However, technology is always combined with undesired side-effects, such as environmental pollution and cost explosion, as long as it has to meet the increasing requirements of mankind. Physicists and engineers were paying attention to these side-effects long before the so-called critical intelligentsia appeared on the scene. It is noteworthy that, especially in Germany, the natural sciences could never be integrated into culture. As a result of this, many scholars argue against technology without presenting solutions for the actual problems that are at present created by the ever-increasing numbers of people in the world and their high demands. Only science and technology can help to overcome these difficulties if they are applied in a reasonable way.

Agriculture↗

On the battle between behavior and cognition: lessons from physicists and pragmatists.

Despite several decades of empirical research that has supported the utility of cognitive research and therapy, behaviorists continue to battle with cognitivists on epistemological grounds. Therefore, I seek to resolve this battle by reviewing epistemological lessons learned from two other disciplines, Physics and Pragmatism. Paradigm shifts in Physics taught us that formal models of phenomena and causality have just as valuable a role in a science of human behavior as models based on efficient cause and direct observation. Cognitive models have proven their worth as formal models of psychology. Pragmatism has taught us that accountability--to the researcher and theorist, to the clinical professional, and to the consumer of care--needs to be a renewed value in evaluating psychological models. Carefully controlled empirical research has shown cognitive models to have ably met these goals. Therefore, cognition meets epistemological criteria, other than those touted by behaviorists, which commend it as an important model for human psychology.

Behavior↗

World hypotheses and the evolution of integrative medicine: combining categorical diagnoses and cause-effect interventions with whole systems research and nonvisualizable (seemingly "impossible") healing.

It has been proposed that to understand (1) the evolution of science and medicine, and (2) the integration of conventional, complementary and alternative medicine, it is essential to consider at least eight universal implicit meta-cognitive hypotheses. It has been suggested that these implicit "world" hypotheses can be applied in every discipline of science. The present paper reviews the eight world hypotheses and proposes an additional hypothesis, termed the nonvisualizable or "Nth" world hypothesis (adopting the mathematical concept of "N"; eg, as in N dimensional space). Drawing on contemporary mathematics and quantum physics, we propose that certain theories and data-by their inherent nature-can not be visualized, and therefore may seem "unimaginable" and "impossible" (if not "unbelievable"), even though they are real. Certain seemingly anomalous observations in mind-body and energy medicine, including areas historically labeled as parapsychology or spiritual energy healing, often elicit strongly skeptical and dismissive reactions. We propose that these skeptical and dismissive reactions to purportedly impossible (yet logical) theories and seemingly unbelievable (yet replicable) data can be tempered when the Nth world hypothesis is understood and incorporated. Integrity in evidence-based science and medicine may require that scientists and nonscientists alike develop comfort and humility in accepting the human mind's restricted ability to envision and imagine certain nonvisualizable-yet fundamental and real-concepts and effects, as illustrated in contemporary physics and complementary and alternative medicine.

Clinical Medicine↗

Higher-order behavior classes: contingencies, beliefs, and verbal behavior.

The concepts of reinforcement and of higher-order classes of behavior are reviewed and applied to analyses of self-reinforcement, self-efficacy, the causal status of private events, and the role of verbal behavior in human action. The analyses support the case that Bandura's criticisms of behavior analytic thought rest upon several misunderstandings, the most important of which are the distinctions between theories and phenomena and a neglect of the process of ontogenic selection. Bandura's persistence in promoting these misunderstandings is puzzling, because over a period of at least two decades he has repeated without substantial correction arguments that were refuted at the time he first made them. Bandura's views on these concepts can be interpreted as a contemporary variety of creationism in behavioral science.

Association Learning↗

Emergent information. Towards a unified information theory.

This paper proposes the restoration of information theory by means of a philosophy of evolutionary systems. What this philosophy implies for the conception of information may be called a multi-stage model, comprising both the history and the ordering of information processing by real-world systems. Such a unifying information concept may assist suitable research in the coming field of information science.

Biological Evolution↗

Informed consent for medical research by the elderly.

Much has been written about the possible lack of capacity of the elderly, especially certain vulnerable populations of older individuals, to give informed consent for medical research. Several small studies have shown a deficit for comprehension of consent material, by the elderly, especially those with less education, but this appears small in comparison to an overall deficit in the general population. A number of investigations have suggested that deficits in executive control functions (ECFs) may be related to lack of capacity to make clinical judgments, but these have yet to be applied to research. Many methods have been piloted to measure capacity and to improve comprehension, some of which may help, although none has been proved conclusively to do either. As the elderly experience significant morbidity and mortality from a vast array of illnesses, the use of the elderly as subjects of medical research is especially important. To prevent older individuals from being coerced into participating or potentially being harmed by scientific investigation, they must give informed consent to their involvement. However, there are many studies to suggest that they are not well informed. A discussion ensued in the 1970s and 1980s about whether or not the elderly deserved special protection as a class of individuals, based on their possible increased risk during medical experimentation, but it was ultimately decided that, because the majority of elderly are perceived to be cognitively intact, they need not receive additional safeguards (High & Doole, 1995, Behavioral Science and Law, 13, 319-335). The U.S. Department of Health and Human Services in 2000 (Federal Registrar Rules and Regulations, 46, 8366-8392) reviewed existing protections for subjects of human research and deemed they were inadequate, issuing new guidelines. This article reviews evidence that differences exist between the ability of young and old in their capacity to give consent. Alterations in methods of obtaining consent may help individuals to give a more informed consent, and even enable subjects who lack the capacity to consent, such as cognitively impaired individuals, to participate in research. However an ideal means of screening or altering the consent process has yet to be devised. Many of these methods are briefly considered.

Aged↗

Pregnancy and post partum: changes in cognition and mood.

Steroidal hormones are increasingly recognized as highly relevant in multiple aspects of brain functioning. While basic science has actively worked to advance understanding of fundamental steroid mechanisms within the brain, investigation of the neurobehavioral outcomes of reproductive hormone actions on the human brain has received less attention. We argue that the dramatic steroidal hormone changes seen in human reproduction must be systematically studied and may provide novel explanations of cognitive and mood disorders associated with reproductive events. This chapter provides a review of current literature establishing a role for a variety of steroids on neuroactivity, and evidence from a variety of observational and experimental paradigms linking hormones and clinical aspects of cognition and mood in humans. The specific hormonal changes of pregnancy are described and discussed in relation to concomitant alterations in cognition and mood across the peri-natal period. A review of studies that have systematically observed cognitive and affective changes both during pregnancy and the post-partum period is presented, as well as new data that follow a small cohort of women for an extended period of time after delivery. We conclude that women may show specific areas of cognitive changes during and after pregnancy, notably deficits in verbal learning and memory. Mood appears to be impacted as well. While steroidal hormones show a pattern of associations with mood during and after pregnancy, no such pattern is evident for cognition. The embryonic state of our knowledge regarding reproductive hormones and neurobehavioral functioning is evident, as are the scientific and public health reasons to redress this lacuna.

Affect↗