That conditional, if-then reasoning does not emerge until 4–5 years has long been accepted. Here we show that children barely 3 years old can do conditional reasoning. All that was needed was a superficial change to the stimuli: When color was a property of the shapes rather than of the background, 3-year-olds could succeed. Three-year-olds do not seem to use color to inform them which shape is correct unless color is a property of the shapes themselves. While CD requires integrating (...) color and shape information, the dimensional change card sort task requires keeping those dimension cognitively separate – inhibiting attention to one when sorting by the other. For DCCS, a superficial change to the stimuli that is the inverse of what helps on CD enables 3-year-olds to succeed when normally they do not until ∼4⁤12 years. As we and others have previously shown, 3-year-olds can succeed at DCCS when color is a property of the background, instead of a property of the stimulus. Our findings on CD and DCCS suggest that scaffolding preschoolers’ emerging conceptual skills by changing the way stimuli look enables 3-year-olds to demonstrate reasoning abilities long thought beyond their grasp. Evidently, children of 3 years have difficulty mentally separating dimensions of the same object and difficulty mentally integrating dimensions not part of the same object. Our present CD findings plus our earlier DCCS findings provide strong evidence against prominent cognitive complexity, conditional reasoning, and graded memory theories for why 3-year-olds fail these two tasks. The ways we have traditionally queried children may have obscured the budding reasoning competencies present at 3 years of age. (shrink)

Human motor learning is governed by a suite of interacting mechanisms each one of which modifies behavior in distinct ways and rely on different neural circuits. In recent years, much attention has been given to one type of motor learning, called motor adaptation. Here, the field has generally focused on the interactions of three mechanisms: sensory prediction error SPE-driven, explicit, and reinforcement learning. Studies of these mechanisms have largely treated them as modular, aiming to model how the outputs of each (...) are combined in the production of overt behavior. However, when examined closely the results of some studies also suggest the existence of additional interactions between the sub-components of each learning mechanism. In this perspective, we propose that these sub-component interactions represent a critical means through which different motor learning mechanisms are combined to produce movement; understanding such interactions is critical to advancing our knowledge of how humans learn new behaviors. We review current literature studying interactions between SPE-driven, explicit, and reinforcement mechanisms of motor learning. We then present evidence of sub-component interactions between SPE-driven and reinforcement learning as well as between SPE-driven and explicit learning from studies of people with cerebellar degeneration. Finally, we discuss the implications of interactions between learning mechanism sub-components for future research in human motor learning. (shrink)

IntroductionDeep brain stimulation (DBS) is increasingly used to treat the symptoms of various neurologic and psychiatric conditions. People can undergo the procedure during reproductive years but the safety of DBS in pregnancy remains relatively unknown given the paucity of published cases. We thus conducted a review of the literature to determine the state of current knowledge about DBS in pregnancy and to determine how eligibility criteria are approached in clinical trials with respect to pregnancy and the potential for pregnancy.MethodsA literature (...) review was conducted in EMBASE to identify articles involving DBS and pregnancy. Two reviewers independently analyzed the articles to confirm inclusion. Data extracted for analysis included conditions treated, complications at all stages of pregnancy, neonatal/pediatric outcomes, and DBS target. A second search was then conducted using www.clinicaltrials.gov. The same two reviewers then assessed whether each trial excluded pregnant individuals, lactating individuals, or persons of childbearing age planning to conceive. Also assessed was whether contraception had to be deemed adequate prior to enrollment.ResultsThe literature search returned 681 articles. Following independent analysis and agreement of two reviewers, 8 pregnancy related DBS articles were included for analysis. These articles described 27 subjects, 29 pregnancies (2 with subsequent pregnancies), and 31 infants (2 twin pregnancies). There was 1 preterm birth at 35 weeks, and 3 patients who experienced discomfort from the DBS battery (i.e., impulse generator) placement site. All 27 patients had a DBS device implanted before they became pregnant, which remained in use throughout their pregnancy. There was exclusion of pregnant individuals from 68% of 135 interventional trials involving DBS. Approximately 44% of these trials excluded persons of childbearing age not on “adequate contraception” or wishing to conceive in the coming years. Finally, 22% excluded breastfeeding persons.ConclusionThe data from 29 pregnancies receiving DBS treatment during pregnancy was not associated with unexpected pregnancy or post-partum complication patterns. Many clinical trials have excluded pregnant individuals. Documentation of outcomes in larger numbers of pregnancies will help clarify the safety profile and will help guide study designs that will safely include pregnant patients. (shrink)

The practice of covertly administering medication is controversial. Although condemned by some as overly paternalistic, others have suggested that it may be acceptable if patients have permanent mental incapacity and refuse needed treatment. Ethical, legal, and clinical considerations become more complex when the mental incapacity is temporary and when the medication actually serves to restore autonomy. We discuss these issues in the context of a young man with schizophrenia. His mother had been giving him antipsychotic medication covertly in his soup. (...) Should the doctor continue to provide a prescription, thus allowing this to continue? We discuss this case based on the “four principles” ethical framework, addressing the conflict between autonomy and beneficence/non-maleficence, the role of antipsychotics as an autonomy restoring agent, truth telling and the balance between individual versus family autonomy. (shrink)

Using a classical conditioning technique, this study investigated whether nonconscious associative learning could be indexed by event-related brain activity . There were three phases. In a preconditioning baseline phase, pleasant and unpleasant facial schematics were presented in awareness . A conditioning phase followed, in which stimuli were presented outside awareness , with an unpleasant face linked to an aversive shock and a pleasant face not linked to a shock. The third, postconditioning phase, involved stimulus presentations in awareness . Evidence for (...) acquisition of a conditional response was sought by comparing suprathreshold pre- and postconditioning phases, as well as in the subthreshold conditioning phase itself. For the pre-postconditioning phase analyses, significant ERP component differences differentiating CS+ and CS− were observed for N1, P2, and especially P3. For the conditioning phase, significant differences were observed in the 100–400 ms. post-stimulus region reflecting a CS+ processing negativity. Brain activity does indeed index the acquisition of a conditional response to subthreshold stimuli. Associative learning can occur outside awareness. (shrink)

BackgroundThere is increasing need for peer reviewers as the scientific literature grows. Formal education in biostatistics and research methodology during residency training is lacking. In this pilot study, we addressed these issues by evaluating a novel method of teaching residents about biostatistics and research methodology using peer review of standardized manuscripts. We hypothesized that mentored peer review would improve resident knowledge and perception of these concepts more than non-mentored peer review, while improving review quality.MethodsA partially blinded, randomized, controlled multi-center study (...) was performed. Seventy-eight neurology residents from nine US neurology programs were randomized to receive mentoring from a local faculty member or not. Within a year, residents reviewed a baseline manuscript and four subsequent manuscripts, all with introduced errors designed to teach fundamental review concepts. In the mentored group, mentors discussed completed reviews with residents. Primary outcome measure was change in knowledge score between pre- and post-tests, measuring epidemiology and biostatistics knowledge. Secondary outcome measures included level of confidence in the use and interpretation of statistical concepts before and after intervention, and RQI score for baseline and final manuscripts.ResultsSixty-four residents (82%) completed initial review with gradual decline in completion on subsequent reviews. Change in primary outcome, the difference between pre- and post-test knowledge scores, did not differ between mentored (−8.5%) and non-mentored (−13.9%) residents (p = 0.48). Significant differences in secondary outcomes (using 5-point Likert scale, 5 = strongly agree) included mentored residents reporting enhanced understanding of research methodology (3.69 vs 2.61; p = 0.001), understanding of manuscripts (3.73 vs 2.87; p = 0.006), and application of study results to clinical practice (3.65 vs 2.78; p = 0.005) compared to non-mentored residents. There was no difference between groups in level of interest in peer review (3.00 vs 3.09; p = 0.72) or the quality of manuscript review assessed by the Review Quality Instrument (RQI) (3.25 vs 3.06; p = 0.50).ConclusionsWe used mentored peer review of standardized manuscripts to teach biostatistics and research methodology and introduce the peer review process to residents. Though knowledge level did not change, mentored residents had enhanced perception in their abilities to understand research methodology and manuscripts and apply study results to clinical practice. (shrink)

Using professional accountants as respondents in Hong Kong, this study strives to develop a model to depict the effect of ethical reasoning on the relationships between guanxi and auditors; behaviour in an audit conflict situation. The results of the study found that (1) there is a significant relationship between an auditor's ethical judgement and one's moral cognitive development; (2) there is a relationship between an auditor's ethical judgement and the existence of guanxi; and (3) the impact of guanxi on an (...) auditor's judgement is depending on the level of ethical reasoning. (shrink)

Objective: To determine the usefulness of Q methodology to locate and describe shared subjective influences on clinical decision making among participant physicians using hypothetical cases containing common ethical issues. Design: Qualitative study using by-person factor analysis of subjective Q sort data matrix. Setting: University medical center. Participants: Convenience sample of internal medicine attending physicians and house staff (n = 35) at one midwestern academic health sciences center. Interventions: Presented with four hypothetical cases involving urgent decision making near the end of (...) life, participants selected one of three specific clinical actions offered for each case. Immediately afterward and while considering their decision, each respondent sorted twenty-five subjective self-referent items in terms of the influence of each statement on their decision-making process. By-person factor analysis, where participants are defined as variates, yielded information about the attitudinal background the physicians brought to their consideration of each hypothetical case. We performed a second-order factor analysis on all of the subjective viewpoints to determine if a smaller core of shared attitudes existed across some or all of the four case vignettes. Factor scores for each item and post-sort comments from interviews conducted individually with each respondent guided the interpretation of ethical perspective used by these respondents in making clinical decisions about the cases. Measurements and Main Results: Second-order factor analysis on seventeen viewpoints used by physicians in the four hypothetical urgent decision cases revealed three moderately correlated (r 2 < 40%) subjective core attitudinal guides used broadly among all the cases and among sixteen of the seventeen original factors. Across all the cases, our participants were guided in general by: (1) patient-focused beneficence, (2) a patient- and surrogate-focused perspective that includes risk avoidance, and (3) best interest of the patient guided by ethical values. Economic impact on the physician, expediency in resolution of the situation, and the expense of medical treatment were not found to be influential determinants in this study. Conclusions: Q sorting and by-person factor analysis are useful qualitative methodological tools to study the complex structure of subjective attitudes that influence physicians in making medical decisions. This study revealed the subjective viewpoints used by our physician participants as they made ethically challenging treatment decisions. The three second-order factors identified here are grounded in current bioethical values as well as the personal traits of physicians. The participants' decision methods appear to resemble casuistry more than principle-based decision making. Generalizability of results will require further studies. (shrink)

Background: Freezing of gait is a common symptom in Parkinson’s disease and can be difficult to treat with dopaminergic medications or with deep brain stimulation. Novel stimulation paradigms have been proposed to address suboptimal responses to conventional DBS programming methods. Burst-cycling deep brain stimulation delivers current in various frequencies of bursts, while maintaining an intra-burst frequency identical to conventional DBS.Objective: To evaluate the safety and tolerability of BCDBS in PD patients with FOG.Methods: Ten PD subjects with STN or GPi DBS (...) and complaints of FOG were recruited for this single center, single blinded within-subject crossover study. For each subject, we compared 4, 10, and 15 Hz BCDBS to conventional DBS during the PD medication-OFF state.Results: There were no serious adverse events with BCDBS. It was feasible and straightforward to program BCDBS in the clinic setting. The benefit was comparable to conventional DBS in measures of FOG, functional mobility and in PD motor symptoms. BCDBS had lower battery consumption when compared to conventional DBS.Conclusions: BCDBS was feasible, safe and well tolerated and it has potential to be a viable future DBS programming strategy. (shrink)

Using a classical conditioning technique, this study investigated whether nonconscious associative learning could be indexed by event-related brain activity . There were three phases. In a preconditioning baseline phase, pleasant and unpleasant facial schematics were presented in awareness . A conditioning phase followed, in which stimuli were presented outside awareness , with an unpleasant face linked to an aversive shock and a pleasant face not linked to a shock. The third, postconditioning phase, involved stimulus presentations in awareness . Evidence for (...) acquisition of a conditional response was sought by comparing suprathreshold pre- and postconditioning phases, as well as in the subthreshold conditioning phase itself. For the pre-postconditioning phase analyses, significant ERP component differences differentiating CS+ and CS− were observed for N1, P2, and especially P3. For the conditioning phase, significant differences were observed in the 100–400 ms. post-stimulus region reflecting a CS+ processing negativity. Brain activity does indeed index the acquisition of a conditional response to subthreshold stimuli. Associative learning can occur outside awareness. (shrink)

Family migration often disadvantages women’s careers. Yet, we know little about the decision-making processes that lead to such outcomes. To address this gap, I conducted a longitudinal interview study of 21 heterosexual young adult couples who were deciding whether to move for early career opportunities. Analyzing 118 interviews, I detail how partners negotiate their desired work and family arrangements given structural and cultural constraints. On one negotiation trajectory, partners maintained their egalitarian desires by performing practical labor to make equal work–family (...) arrangements. On another pathway, couples changed their desires by doing emotion work to justify neotraditional roles. On the last pathway, men deferred to women’s desires, unintentionally leaving women the emotional and practical work of coordinating two careers and the couple’s life. These pathways show how couples contest and reproduce gendered work and family roles during the stalled gender revolution. (shrink)

I thought the paper by Kai-yee Wong and Chris Fraser was fascinating and insightful. Two things I especially appreciated are the clarity with which they summarize my views. I think they are quite fair and accurate. Second, I appreciate their suggestion that the way to deal with the practical problem of weakness of will has much to do with the role of the Background in shaping our actions. I think they are especially on the right track when they say (...) that the improvement of Background skills may actually narrow the range of real options for action, (p. 21) nonetheless, they do not decrease freedom. As they say, “It is a process of strengthening the self, and the agent is likely to experience the concomitant restriction of ‘live’ options not as a limitation but as strength of character.” (p. 21). That seems to me very much on the right track. What they are suggesting, and it is a powerful addition to my own writings, is that we should not just think of the Background as facilitating languages, games and social practices generally, but for morality as well (p. 23). (shrink)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

This anthology examines the practical role of well-being in contemporary society. It discusses developments such as globalization, consumerism and the rapid innovation and use of new and emerging technologies and focuses on the significant impact of these developments on the well-being of people living today. The anthology brings together researchers from various disciplines, including psychology, economics, sociology, philosophy and development studies. It provides concrete insight on the role and importance of well-being in contemporary society, using a mix of empirical grounding, (...) philosophical rigour and an emphasis on real-world applications. It is unique in that it seeks to understand the relation between well-being research and its application towards real problems. (shrink)

This paper aims at engaging Kant’s and Schelling’s theories of time in dialogue. It begins with Schelling’s famous criticism of Kant’s theory of time in his Weltalter (Ages of the World). It will examine this question from four main perspectives, namely the unity of time; time and a unitary object of experience;subjectivity of time; and the problem of infinity of time. It will show that Schelling’s criticism may instigate some fundamental reflections on Kant’s theory oftime, the relation between objective and (...) subjective time, and the possibilities of connecting Kant’s different meanings of time in his first Critique. Further, it willshow that despite the fundamental differences between Kant’s and Schelling’s philosophical systems, some of Schelling’s ideas about time may have their earlier expressions in Kant. While Schelling has gone further and radicalized some insights from Kant in his own version of idealism, his criticism of Kant may find possible responses from the latter’s first Critique. (shrink)

The volume is inspired by Gilles Deleuze's philosophical project, which builds on the critique of European Humanism and opens up inspiring new perspectives for the renewal of the field.

Although the teaching of medical ethics and law in medical education is an old story that has been told many times in medical literature, recent studies show that medical students and physicians lack confidence when faced with ethical dilemmas and medico-legal issues. The adverse events rates and medical lawsuits are on the rise whereas many medical errors are mostly due to negligence or malpractices which are preventable. While it is true that many medical schools teach their students medical law and (...) ethics, there are wide variations in what is being taught because there is no universally agreed syllabus. Yet the knowledge of medical law and ethics is closely relevant to the medical profession and that failure in abiding the law may result in serious civil or even criminal consequences. While this paper does not propose to lay detailed analysis of the relevant areas of law or ethics, it proposes to cover some legal areas so as to highlight and bring to attention the need for a medical law and ethics course. This article also considers the problems faced and recommendation as to future directions to be taken with respect to teaching medical law and ethics. It concludes with a suggested course outline for the teaching of medical law and ethics. (shrink)

David B. Wong proposes that there can be a plurality of true moralities, moralities that exist across different traditions and cultures, all of which address facets of the same problem: how we are to live well together. Wong examines a wide array of positions and texts within the Western canon as well as in Chinese philosophy, and draws on philosophy, psychology, evolutionary theory, history, and literature, to make a case for the importance of pluralism in moral life, and (...) to establish the virtues of acceptance and accommodation. Wong's point is that there is no single value or principle or ordering of values and principles that offers a uniquely true path for human living, but variations according to different contexts that carry within them a common core of human values. We should thus be modest about our own morality, learn from other approaches, and accommodate different practices in our pluralistic society. (shrink)

Hegel’s famous criticism of Laozi in his Lectures on the History of Philosophy, has been a center of controversy in comparative philosophy. It is often regarded as an example of the unfair treatment of Chinese philosophy by its Western counterpart, that the West is measuring the East according to its own standard, imposing on the latter its understanding of what philosophy should be, passing judgment on China that it has no mature philosophy, or, if it has, that it is still (...) in an unsophisticated, primitive stage. However, there has been little serious and detailed discussion about Hegel’s argument in this important and representative document in the dialogue between Western and Chinese philosophy. Most of the .. (shrink)

McTaggart’s argument for the unreality of time was first published in the 1908 article “The Unreality of Time,” and a revised version appeared in the 1927 book The Nature of Existence. I argue that these two versions are significantly different. The second construction of the argument is important because it neutralizes a compelling objection. McTaggart’s initial argument tries to show that the conception of an A-series is self-contradictory. A natural objection is that the apparent contradiction can be resolved by making (...) clear that an event has incompatible A-properties only successively. McTaggart anticipates and responds to the objection. My main contention is this: McTaggart’s initial response to the objection fails, but in the second construction of his argument he succeeds in showing that the contradiction cannot be resolved in the way suggested by the objection. I also explain why the second construction has been overlooked for so long. (shrink)

This book is a collection of articles on different aspects of university education in China since the late nineteenth century, addressing how far the ideal of modern university education, which has gradually been developed in the West since the age of European Enlightenment, was adopted or transformed by Chinese universities.

The view defended is one sense externalist on the relation between moral reasons and motivation: A's having a moral reason to do X does not necessarily imply that A has a motivation that would support A's doing X via some appropriate deliberative route. However, it is in another sense externalist in holding that there are the kind of moral reasons there are only if the relevant motivational capacities are "generally present" in human beings, if not in all individuals. The process (...) of socialization is an attempt to embed the recognition of what we have moral reason to do in the intentional content of one's feelings. E.g., learning that about others' suffering embeds their suffering as a reason to help in the intentional content of incipient compassionate feelings. This endows the reason with motivational efficacy while conferring further direction to the feelings in ways that shape us for social cooperation. (shrink)

Abstract: Williamson argues that when one feels cold, one may not be in a position to know that one feels cold. He thinks this argument can be generalized to show that no mental states are such that when we are in them we are in a position to know that we are in them. I argue that his argument is a sorites argument in disguise because it relies on the implicit premise that warming up is gradual. Williamson claims that his (...) argument is not a sorites argument; I explain why he has not given us any reason to accept the claim. (shrink)

Lexical alignment, a communication phenomenon where conversational partners adapt their word choices to become more similar, plays an important role in the development of language and social communication skills. While this has been studied extensively in the conversations of preschool‐aged children and their parents in Western, Educated, Industrialized, Rich, and Democratic (WEIRD) communities, research in other pediatric populations is sparse. This study makes significant expansions on the existing literature by focusing on alignment in naturalistic conversations of school‐aged children from a (...) non‐WEIRD population across multiple conversational tasks and with different types of adult partners. Typically developing children aged 5 to 8 years (n = 45) engaged in four semi‐structured conversations that differed by task (problem‐solving vs. play‐based) and by partner (parent vs. university student), resulting in a corpus of 180 conversations. Lexical alignment scores were calculated and compared to sham conversations, representing alignment occurring at the level of chance. Both children and adults coordinated their conversational utterances by re‐using or aligning each other's word choices. This alignment behavior persisted across conversational tasks and partners, although the degree of alignment was moderated by the conversational context. These findings suggest that lexical alignment is a robust phenomenon in conversations between school‐age children and adults. Furthermore, this study extends lexical alignment findings to a non‐WEIRD culture, suggesting that alignment may be a coordination strategy employed by adults and children across diverse linguistic and cultural backgrounds. (shrink)