Recognizing and aligning individuals’ unique adaptive beliefs or “priors” through cooperative communication is critical to establishing a therapeutic relationship and alliance. Using active inference, we present an empirical integrative account of the biobehavioral mechanisms that underwrite therapeutic relationships. A significant mode of establishing cooperative alliances—and potential synchrony relationships—is through ostensive cues generated by repetitive coupling during dynamic touch. Established models speak to the unique role of affectionate touch in developing communication, interpersonal interactions, and a wide variety of therapeutic benefits for (...) patients of all ages; both neurophysiologically and behaviorally. The purpose of this article is to argue for the importance of therapeutic touch in establishing a therapeutic alliance and, ultimately, synchrony between practitioner and patient. We briefly overview the importance and role of therapeutic alliance in prosocial and clinical interactions. We then discuss how cooperative communication and mental state alignment—in intentional communication—are accomplished using active inference. We argue that alignment through active inference facilitates synchrony and communication. The ensuing account is extended to include the role of tactile afferents in realizing the beneficial effect of therapeutic synchrony. We conclude by proposing a method for synchronizing the effects of touch using the concept of active inference. (shrink)

IntroductionHearing loss in adults has a pervasive impact on health and well-being. Its effects on everyday listening and communication can directly influence participation across multiple spheres of life. These impacts, however, remain poorly assessed within clinical settings. Whilst various tests and questionnaires that measure listening and communication abilities are available, there is a lack of consensus about which measures assess the factors that are most relevant to optimising auditory rehabilitation. This study aimed to map current measures used in published studies (...) to evaluate listening skills needed for oral communication in adults with hearing loss.MethodsA scoping review was conducted using systematic searches in Medline, EMBASE, Web of Science and Google Scholar to retrieve peer-reviewed articles that used one or more linguistic-based measure necessary to oral communication in adults with hearing loss. The range of measures identified and their frequency where charted in relation to auditory hierarchies, linguistic domains, health status domains, and associated neuropsychological and cognitive domains.Results9121 articles were identified and 2579 articles that reported on 6714 discrete measures were included for further analysis. The predominant linguistic-based measure reported was word or sentence identification in quiet. In contrast, discourse-based measures were used in 2.7% of the articles included. Of the included studies, 36.6% used a self-reported instrument purporting to measures of listening for communication. Consistent with previous studies, a large number of self-reported measures were identified, but 60.4% of these measures were used in only one study and 80.7% were cited five times or fewer.DiscussionCurrent measures used in published studies to assess listening abilities relevant to oral communication target a narrow set of domains. Concepts of communicative interaction have limited representation in current measurement. The lack of measurement consensus and heterogeneity amongst the assessments limit comparisons across studies. Furthermore, extracted measures rarely consider the broader linguistic, cognitive and interactive elements of communication. Consequently, existing measures may have limited clinical application if assessing the listening-related skills required for communication in daily life, as experienced by adults with hearing loss. (shrink)

This study investigated the relationship between concussions and medication adherence among 247 adults experiencing homelessness in Oklahoma City, Oklahoma, who were prescribed medication for a psychiatric disorder. Participants were asked whether they had “ever experienced a blow to the head that caused a concussion,” and medication adherence was measured by asking participants whether they had taken their psychiatric medication yesterday. The data were analyzed using univariate and multivariable logistic regressions. Results showed that more than half of the sample had a (...) concussion history, and homeless adults with a concussion history had higher odds of non-adherence to psychiatric medications compared with those who reported no concussion history [OR = 2.13 ]. Findings suggest that medication non-adherence is associated with incurred concussions. Raising awareness among service providers of the relationship between traumatic brain injury and medication adherence may increase efforts to improve adherence in this underserved population. (shrink)

This article addresses Dutch architect Rem Koolhaas's notion of ‘Junkspace’ Š infinitely reconfigurable, physical space that is always-already in transition, perpetually in a state of becoming Š and its implications for theology. Junkspace is the logical result of a culture in which ‘shopping’ is the last public activity. All public institutions Š churches, museums, the internet, hospitals, universities and airports Š increasingly are drawn into this framework. While this schema represents the suburban desire for control and predictability, it consequently flattens (...) intellectual terrain. In other words, we have come to the point of shopping for politics, knowledge, ideology and theology. Rather than critique this hypothesis, the article explores its possibilities for new understandings of the secular, our desire for ‘the new’, and our need to intentionally forget or disavow. I argue that Junkspace may serve as a promising new metaphorical lens for theological reflection, which is now rendered provisional, incomplete, and migratory. (shrink)

There is limited knowledge about cancer patients' experiences of uncertainty while waiting for genome sequencing results, and whether prolonged uncertainty contributes to psychological factors in this context. To investigate uncertainty in patients with a cancer of likely hereditary origin while waiting for genome sequencing results, we collected questionnaire and interview data at baseline, and at three and 12 months follow up. Participants had negative attitudes towards uncertainty at baseline, and low levels of uncertainty at three and 12 months. Uncertainty about (...) genome sequencing did not change significantly over time [t = 0.660, p = 0.510]. Greater perceived susceptibility for cancer [r = 0.14, p < 0.01], fear of cancer recurrence [r = 0.19, p < 0.01], perceived importance of genome sequencing [r = 0.24, p < 0.01], intention to change behavior if a gene variant indicating risk is found [r = 0.29, p < 0.01], perceived ability to cope with results [r = 0.36, p < 0.01], and satisfaction with decision to have genome sequencing [r = 0.52, p < 0.01] were significantly correlated with negative attitudes towards uncertainty at baseline. Multiple primary cancer diagnoses [B = −2.364 [−4.238, −0.491], p = 0.014], lower perceived ability to cope with results [B = −0.1.881 [−3.403, −0.359], p = 0.016] at baseline, greater anxiety about genome sequencing [B = 0.347 [0.148, 0.546], p = 0.0012] at 3 months, and greater perceived uncertainty about genome sequencing [B = 0.494 [0.267, 0.721] p = 0.000] at 3 months significantly predicted greater perceived uncertainty about genome sequencing at 12 months. Greater perceived uncertainty about genome sequencing at 3 months significantly predicted greater anxiety about genome sequencing at 12 months [B = 0.291 [0.072, 0.509], p = 0.009]. Semi-structured interviews revealed that while participants were motivated to pursue genome sequencing as a strategy to reduce their illness and risk uncertainty, genome sequencing generated additional practical, scientific and personal uncertainties. Some uncertainties were consistently discussed over the 12 months, while others emerged over time. Similarly, some uncertainty coping strategies were consistent over time, while others emerged while patients waited for their genome sequencing results. This study demonstrates the complexity of uncertainty generated by genome sequencing for cancer patients and provides further support for the inter-relationship between uncertainty and anxiety. Helping patients manage their uncertainty may ameliorate psychological morbidity. (shrink)

Safe-by-design aims at addressing safety issues already during the R&D and design phases of new technologies. SbD has increasingly become popular in the last few years for addressing the risks of emerging technologies like nanotechnology and synthetic biology. We ask to what extent SbD approaches can deal with uncertainty, in particular with indeterminacy, i.e., the fact that the actual safety of a technology depends on the behavior of actors in the value chain like users and operators. We argue that while (...) indeterminacy may be approached by designing out users as much as possible in attaining safety, this is often not a good strategy. It will not only make it more difficult to deal with unexpected risks; it also misses out on the resources that users can bring for achieving safety, and it is undemocratic. We argue that rather than directly designing for safety, it is better to design for the responsibility for safety, i.e., designers should think where the responsibility for safety is best situated and design technologies accordingly. We propose some heuristics that can be used in deciding how to share and distribute responsibility for safety through design. (shrink)

Aggleton & Brown argue that a hippocampal-anterior thalamic system supports the “recollection” of contextual information about previous events, and that a separate perirhinal-medial dorsal thalamic system supports detection of stimulus “familiarity.” Although there is a growing body of human literature that is in agreement with these claims, when recollection and familiarity have been examined in amnesics using the process dissociation or the remember/know procedures, the results do not seem to provide consistent support. We reexamine these studies and describe the results (...) of an additional experiment using a receiver operating characteristic (ROC) technique. The results of the reanalysis and the ROC experiment are consistent with Aggleton & Brown's proposal. Patients with damage to both regions exhibit severe deficits in recollection and smaller, but consistent, deficits in familiarity. (shrink)

This study investigated whether some Japanese intransitive verbs, called agent-implying intransitive verbs, are processed differently from other ordinary intransitive verbs. These verbs are special in that they denote agentive events, but they are intransitive verbs, which only allow the patient/theme to be the only nominatively marked argument. The priming experiment was designed based on the situation model theory, assuming that verbs with an agentive semantic structure (e.g., ordinary transitive verbs) has a shorter causal inferential distance than those with a non-agentive (...) semantic structure (e.g., ordinary intransitive verb). In the experiment, participants were instructed to read two sentences that formed a story, of which the second sentence was either a transitive or intransitive sentence. The participants then answered a related question about general knowledge, and their response times were measured. The results show that, whereas the mean response time in the ordinary intransitive condition was significantly longer than that in the ordinary transitive condition, the mean response time in the agent-implying intransitive condition was not significantly different from that of the corresponding transitive condition, suggesting that agent-implying intransitive verbs are interpreted as agentive. The findings suggest that agent-implying intransitive verbs instantly evoke agentivity, whereas ordinary intransitive verbs do not. The theoretical implications of the findings are discussed. (shrink)

This book builds on the idea that pragmatics and philosophy are strictly interconnected and that advances in one area will generate consequential advantages in the other area. The first part of the book, entitled ‘Theoretical Approaches to Philosophy of Language’, contains contributions by philosophers of language on connectives, intensional contexts, demonstratives, subsententials, and implicit indirect reports. The second part, ‘Pragmatics in Discourse’, presents contributions that are more empirically based or of a more applicative nature and that deal with the pragmatics (...) of discourse, argumentation, pragmatics and law, and context. The book presents perspectives which, generally, make most of the Gricean idea of the centrality of a speaker’s intention in attribution of meaning to utterances, whether one is interested in the level of sentence-like units or larger chunks of discourse. (shrink)

En este artículo me propongo examinar algunos casos de reconocimiento de emociones que parecieran estar constreñidos por información cognitiva de algún tipo. Usualmente, se ha explicado al reconocimiento de emociones como una habilidad directa, no-inferencial, que descansa en la detección de un conjunto de información perceptiva de carácter multimodal. No obstante, existe evidencia empírica relativa al reconocimiento de emociones que no pareciera ser explicada fácilmente por los enfoques no-inferencialistas debido a que existe algún tipo de influencia top-down entre cierto tipo (...) estados cognitivos y perceptuales que desafía el carácter directo o no inferencial de esta habilidad. Específicamente, la integración de esa información podría involucrar mecanismos inferenciales o cognitivamente más demandantes que los propuestos por las teorías de la percepción directa de emociones. Particularmente, me refiero a la evidencia de la influencia que poseen los sesgos cognitivos, prejuicios y otras creencias en el reconocimiento de emociones. Propondré que estos casos de reconocimiento de emociones si pueden explicarse por medio de enfoques no inferencialistas si se apela a fenómenos como el de la penetrabilidad cognitiva. (shrink)