Aim: To assess, against a checklist of specific areas of required information and using standard published criteria, to what extent leaflets given before cataract surgery provided patients with enough information to give adequately informed consent.Method: Twelve ophthalmology departments in the West Midlands region were asked to submit the cataract information leaflets given to their patients at the preoperative assessment for analysis. Using criteria published by the General Medical Council, British Medical Association, and Medical Defence Union (...) the leaflets were assessed for their contribution to informed consent for patients considering cataract surgery. Leaflets were scored according to the information they provided on: diagnosis, prognosis, treatment options, costs to the patient, details about the procedure, its purpose, likely benefits, how to prepare for it, what to expect during and after the operation, and the common as well as serious complications that may occur. The readability of the information was also assessed.Results: All the units’ leaflets provided information on diagnosis, the lifestyle changes required postoperatively, and cost involved to the patient. Only five units had leaflets that mentioned the risks involved in cataract surgery. The other areas of information were covered by 50–75% of the leaflets. Fifty per cent of the leaflets included a diagram. The average SMOG readability score was high.Conclusion: Although present cataract information leaflets make some contribution to the process of informed consent, most do not address important areas outlined by the General Medical Council. Many of the areas of information that are required for informed consent could easily be covered, and should be borne in mind when designing patient information leaflets. Resources are available on the internet including toolkits, guides, and means of assessment for the production of patient information leaflets. (shrink)

This study explores society's attitudes towards medicine, as reflected in the language of Patient Information Leaflets, and attempts to explicate how they have changed over the last century. For this purpose, Halliday's transitivity model is employed as a method of discourse analysis in order to carry out a systematic, comparative investigation of the language of early 20th-century PILs and that of their modern equivalents. The study demonstrates how the transitivity choices in the respective samples cumulatively realize a particular (...) `world-view', and considers the implications this has for the construal of the wider social/cultural context and the projection of particular ideologies. The analyses show significant differences in transitivity patterns between the two samples, which reflect changes in the way medicine is viewed in Western culture. (shrink)

The problem of non-compliance with treatment and its repercussions on the clinical evolution of different conditions has been widely investigated.1–4 Non-compliance has also been shown to have significant economic implications, not only as a result of product loss but also indirectly through the complication of disease management and its subsequent healthcare and social costs.5–7Non-compliance as a health problemThe term “non-compliance” might be taken to refer both to the failure to follow a drug regimen and to the failure to adopt other (...) measures that contribute to improvement in health—for example, changes in lifestyle or diet. This letter focuses on the former.Non-compliance with a drug regimen can be the result of a number of different factors9–11 and a variety of techniques have been developed in an attempt to control it.12,13 Of these, the few techniques that have been shown to be effective have only managed to solve the problem in specific situations over short periods of time. The use of such techniques to control non-compliance, particularly where these are effective, raises interesting ethical questions about the extent to which their application constitutes an infringement of the patient’s right to decide on how to manage their own health.8 Here we suggest that in some cases one factor that leads to non-compliance is the tendency to provide extensive and exhaustive information on side effects in …. (shrink)

Package leaflets belong to the complex communication system related to the minimization and prevention of pharmaceutical risk. Their legal nature is not exhausted by safety regulation though: as a privileged form of product instruction, they are also subject to liability regulation with a consequent reallocation of damage responsibility through risk disclosure. This article presents the results of a doctoral dissertation devoted to the legal and communicative analysis of PL information. After illustrating the articulation of pharmaceutical risk through risk (...) prevention norms, the paper goes on with a discussion of the PL role within the therapeutic decision as a complementary vehicle to doctor’s information. It results that the liability framework in which both information channels are embedded determines a communication model, which far from promoting a shared decision process, radicalizes the two-step communication structure typical of the informed consent model inherited by surgery judicature. The second part investigates PL information as a source of knowledge updating through the methodological tools provided by Bayesian decision theory. Finally, an empirical study conducted over a sample of 55 drug consumers investigates the impact of PL information on drug risk perception and its perceived value to therapeutic decision. (shrink)

BackgroundApproval of the research proposal by an ethical review committee from both sponsoring and host countries is a generally agreed requirement in externally sponsored research.However, capacity for ethics review is not universal. Aim of this study was to identify opinions and views of the members serving in ethical review and ethics committees in Sri Lanka on informed consent, essential components in the information leaflet and the consent form.MethodsWe obtained ethical approval from UK and Sri Lanka. A series of consensus (...) generation meetings on the protocol were conducted. A task oriented interview guide was developed. The interview was based on open-ended questionnaire. Then the participants were given a WHO checklist on informed consent and requested to rate the items on a three point scale ranging from extremely important to not important.ResultsTwenty-nine members from ethics committees participated. Majority of participants (23), believed a copy of the information leaflet and consent form, should accompany research proposal. Opinions about the items that should be included in the information leaflets varied. Participants identified 18 criteria as requirements in the information leaflet and 19 for the consent form.The majority, 20 (69%), believed that all research need ethical approval but identified limited human resource, time and inadequate capacity as constraints. Fifteen (52%) believed that written consent is not required for all research. Verbal consent emerged as an alternative to written consent. The majority of participants rated all components of the WHO checklist as important.ConclusionThe number of themes generated for the consent form (N = 18) is as many as for the information leaflet (N = 19) and had several overlaps. This suggests that the consent form should be itemized to reflect the contents covered in the information leaflet. The participants' opinion on components of the information leaflets and consent forms proved to be similar with WHO checklist on informed consent. (shrink)

OBJECTIVES: To study whether linguistic analysis and changes in information leaflets can improve readability and understanding. DESIGN: Randomised, controlled study. Two information leaflets concerned with trials of drugs for conditions/diseases which are commonly known were modified, and the original was tested against the revised version. SETTING: Denmark. PARTICIPANTS: 235 persons in the relevant age groups. MAIN MEASURES: Readability and understanding of contents. RESULTS: Both readability and understanding of contents was improved: readability with regard to both (...) class='Hi'>information leaflets and understanding with regard to one of the leaflets. CONCLUSION: The results show that both readability and understanding can be improved by increased attention to the linguistic features of the information. (shrink)

Background: Informed consent in the modern era is a common and important topic both for the well-informed patient and to prevent unnecessary litigation. However, the effectiveness of informed consent in trauma patients is an under-researched area. This paper aims to assess the differences in patient recall of the consent process and desire for information by performing a comparative analysis between orthopaedic trauma and elective patients. Methods: Information from 41 consecutive elective operations and 40 consecutive trauma operations was collected (...) on the first post-operative day. Results: 100% of elective patients and 90% of trauma patients knew what operation they had received (p = 0.06). Overall recall of complications was poor, but was significantly lower in trauma patients compared with elective patients (62% vs 22%, p<0.001). 30% of trauma patients desired more information about their operation compared to 12% of elective patients (p = 0.049), although only 35% of trauma patients wanted written as well as verbal explanations, compared to 85% of elective patients p<0.001). Overall 100% of elective and 90% of trauma patients were happy with the consent process (p = 0.06). Subset analysis of neck of femur compared to other trauma patients showed that the above factors were not significantly different between the two groups. Conclusions: Recall of complications in the trauma patients is significantly lower than in elective patients, although both groups scored poorly overall. Repeated verbal explanations should be reinforced with the option of additional information leaflets for trauma operations. Further research into the usefulness of DVDs for commonly performed operations is warranted, although official internet resources may be more cost-effective. (shrink)

Aim: The primary aim of the study was to evaluate two different methods of communicating information on cardiopulmonary resuscitation to patients admitted to general medical and elderly care wards. The information was either in the form of a detailed information leaflet or a summary document . The study examined the willingness of patients in seeking detailed information on cardiopulmonary issues.Setting: The study was conducted over three months on a general medical ward and an acute elderly care (...) ward in two district general hospitals.Methods: A detailed information leaflet on CPR was provided to the nursing staff on the wards. An A4 summary document summarising the CPR decision making process and basic information on cardiopulmonary issues was placed in a folder at the foot of each bed on the elderly care ward. On the general medical ward it was displayed prominently over the head of all beds.Results: Out of the 274 patients admitted to the general medical ward only two requests were received for the detailed information leaflet. On the elderly care ward there were 182 admissions but no patients or their relatives requested the leaflet.Conclusions: Availability of basic information on cardiopulmonary resuscitation to all patients is practical and does not lead to unnecessary distress or offence to patients or their carers. It makes the decision making process more transparent. Detailed information leaflets are of value for a minority of hospitalised patients. (shrink)

Radio Free Europe used balloons to drop leaflets in an attempt to supplement radio with printed words in the 1950s—a historical moment when closing borders, censoring the press, jamming foreign radios, tapping telephone lines, and tracking letters from abroad created an almost hermetically sealed space without many means for exchanging information across the Iron Curtain. This article traces how distorted and limited information shaped Cold War propaganda and practices of information-gathering. The article further examines unpredictable environmental (...) factors that were transformed into persuasive political rhetoric. A comparative analysis of communist media shows similarities of imagination in a visual propaganda campaign across five communist countries. Fantasies evolved into an object of public interest when propaganda strategies embraced a language of facts. (shrink)

This clinical ethics case examines whether healthcare providers have an obligation to inform patients about animal-derived ingredients in medications, specifically focusing on a hospitalized patient who may object to porcine-derived heparin on religious grounds. The ethics committee concluded that healthcare providers have a moral obligation to disclose this information to all patients, not just those presumed to have religious or ethical objections, to allow for informed decision-making. While acknowledging practical challenges around information delivery and increased costs of synthetic (...) alternatives, they recommended developing systematic approaches like information leaflets and staff education to address this issue. The committee emphasized there should be no moral distinction between religious and ethical objections to animal products, and that the healthcare system needs to work with faith and advocacy groups to better serve patients' needs while balancing medical necessity with personal beliefs. (shrink)

Context: Despite much research on informed choice and the individuals’ autonomy in organised medical screening, little is known about the individuals’ decision-making process as expressed in their own words.Objectives: To explore the decision-making process among women invited to a mammography screening programme.Setting: Women living in the counties of Sør- and Nord-Trøndelag, Norway, invited to the first round of the Norwegian Breast Cancer Screening Program in 2003.Methods: Qualitative methods based on eight semistructured focus-group interviews with a total of 69 women aged (...) 50–69 years.Results: The decision to attend mammography screening was not based on the information in the invitation letter and leaflet provided by the NBCSP. They perceived the invitation letter with a prescheduled appointment as if a decision for mammography had already been made. This was experienced as an aid in overcoming the postponements that easily occur in daily lives. The invitation to mammography screening was embraced as an indication of a responsible welfare state, “like a mother taking care.”Conclusion: In a welfare state where governmental institutions are trusted, mass screening for disease is acknowledged by screening participants as a valued expression of paternalism. Trust, gratitude, and convenience were more important factors than information about benefits, harms, and risks when the women made their decisions to attend screening. These elements should be included in the ethical debates on informed choice in preventive medicine. (shrink)

Each year in the UK there are approximately 250,000 miscarriages, 3,000 stillbirths and 3,000 terminations following a diagnosis of fetal-abnormality. This paper draws from original empirical research into the experience of pregnancy loss and the accompanying decisionmaking processes. A key finding is that there is considerable variation across England in the range of options that are offered for disposal of pregnancy remains and the ways in which information around disposal are communicated. This analysis seeks to outline the key features (...) of what constitutes effective communication in this context, where effective communication is taken to mean that patients are provided with the key information necessary, in an appropriate manner, so that they are fully able to make a decision. A primary source of evidence includes interviews with the bereaved and pregnancy-loss support workers, in order to understand how the options available, and associated necessary procedures, are communicated. In addition, patient information leaflets are also analyzed as they offer an important tool for information delivery at a difficult and emotionally charged time. Following this, an overview is provided of the information that these leaflets should contain, along with guidance on effective presentation of this information. (shrink)

This article is concerned with the reasons why sometimes good arguments in health communication leaflets fail to convince the targeted audience. As an illustrative example it uses the age-dependent eligibility of women in the Netherlands to receive routine breast cancer screening examinations: according to Dutch regulations women under 50 are ineligible for them. The present qualitative study rests on and complements three experimental studies on the persuasiveness of mammography information leaflets; it uses interviews to elucidate reasons why (...) the arguments in the health communication leaflets for the exclusion of women under 50 from routine mammographic screenings do not work. (shrink)

Background: Surveillance technology such as tag and tracking systems and video surveillance could increase the freedom of movement and consequently autonomy of clients in long-term residential care settings, but is also perceived as an intrusion on autonomy including privacy. Objective: To explore how clients in residential care experience surveillance technology in order to assess how surveillance technology might influence autonomy. Setting: Two long-term residential care facilities: a nursing home for people with dementia and a care facility for people with intellectual (...) disabilities. Methods: Ethnographic field study. Ethical considerations: The boards representing clients and relatives/proxies of the clients were informed of the study and gave their written consent. The clients’ assent was sought through a special information leaflet. At any time clients and/or proxy were given the option to withdraw from the study. The research protocol was also reviewed by a medical ethics committee. Findings: Our findings show a pattern of two themes: (1) coping with new spaces which entailed clients: wandering around, getting lost, being triggered, and retreating to new spaces and (2) resisting the surveillance technology measure because clients feel stigmatized, missed the company, and do not like being “watched.” Conclusion: Client experiences of surveillance technology appear to entail a certain ambivalence. This is in part due to the variety in surveillance technology devices, with each device bringing its own connotations and experiences. But it also lies in the devices’ presupposition of an ideal user, which is at odds with the actual user who is inherently vulnerable. Surveillance technology can contribute to the autonomy of clients in long-term care, but only if it is set in a truly person-centered approach. (shrink)

Professor Duncan Vere lays before us the idealised guidelines used for recruiting volunteers on which to try and test new medicines. He points out that if these were followed rigidly, few, if any volunteers would be found for this vital work. Inducements are used, but the size of these determines whether society deems it right or wrong. However, the aim is to help and advise volunteers of the need for such tests and the risks involved and therefore the information (...) leaflet reprinted as part of the article indicates how the drug testers are attempting to encourage volunteers in as ethical a way as possible. To abandon human tests with new drugs may be unethical. A balance is sought. (shrink)

Objective: To examine lay persons’ ability to identify methods of random allocation and their acceptability of using methods of random allocation in a clinical trial context.Design: Leaflets containing hypothetical medical, non-medical, and clinical trial scenarios involving random allocation, using material from guidelines for trial information leaflets.Setting and participants: Adults attending further education colleges , covering a wide range of ages, occupations, and levels of education.Main measures: Judgements of whether each of five methods of allocation to two groups (...) was random in a medical or non-medical scenario. Judgements of whether these allocation methods were acceptable in a randomised clinical trial scenario, with or without a scientific justification for randomisation.Results: The majority of our group of participants judged correctly that allowing people their preference was not random, and that the following were random: using a computer with no information about the individual , tossing a coin, drawing a name out of a hat. Judgements were split over allocating people in turn . Judgements were no different in medical and non-medical scenarios. Few of the correctly identified random methods were judged to be acceptable in a clinical trial scenario. Inclusion of a scientific justification for randomising significantly increased the acceptability of only one random method: allocation by computer.Conclusions: Current UK guidelines’ recommended description of random allocation by computer seems warranted. However, while potential trial participants may understand what random allocation means, they may find it unacceptable unless offered an acceptable justification for its use. (shrink)

In her 2006 book The Jumbled Jigsaw, Donna Williams, an autistic author and poet, presents an example of a list of traits associated with autism—one of many such lists commonly found in text books, academic publications, and information leaflets. Her list includes the following: a tendency to stick to well-tried routines and avoid change, a tendency to have a narrow range of interests, a tendency to develop irrational fears and anxieties, a tendency not to develop a sense of (...) danger, a tendency to demonstrate bizarre behaviors and mannerisms, a tendency to copy speech parrot fashion, and isolated areas of ability. "The problem with such a list," Williams explains, "is that the features of each of these areas can be... (shrink)

The UK Medical Research Council, in order to further its mission of maintaining and improving human health, supports a substantial number of clinical trials on a wide variety of medical questions; some of these trials involve the use of placebos as controls or to maintain blinding. Before providing support, proposed trials are carefully reviewed to assess scientific quality, and to determine whether a placebo is required and is ethical — in addition to ethics review by independent Research Ethics Committees. Some (...) questions such as the choice of placebos in trials in developing countries, in surgical trials and those involving alternative medicine require consideration of additional, specific issues. Involvement of consumers in MRC work has been increasing and includes the establishment of a Consumer Liaison Group; members of this group comment on patient information leaflets for clinical trials, helping to improve patient understanding of trials and ensuring topics like placebo use are explained clearly. Views differ on the value of placebos in clinical care and on their mechanism of action; continuing research is helping to clarify the issues. (shrink)

The principle of informed consent is now well established within the National Health Service (NHS) in relation to any type of medical treatment. However, this ethical principle appears to be far less well established in relation to medical screening programmes such as Britain's national cervical screening programme. This article will critically examine the case for health care providers vigorously pursuing women to accept an invitation to be screened. It will discuss the type of information which women would need in (...) order to make an informed decision about whether or not to be screened. The lack of such information in current patient leaflets on the "smear test" will then be documented. Finally, the article will explore possible ways of maximising women's autonomy in relation to the cervical screening programme without sacrificing any of its main benefits. (shrink)

Summary Principles Timely support for patients and people close to them, and effective, sensitive communication are essential. Decisions must be based on the individual patient's circumstances and reviewed regularly. Sensitive advance discussion should always be encouraged, but not forced. Information about CPR and the chances of a successful outcome needs to be realistic. Practical matters Information about CPR policies should be displayed for patients and staff. Leaflets should be available for patients and people close to them explaining (...) about CPR, how decisions are made and their involvement in decisions. Decisions about attempting CPR must be communicated effectively to relevant health professionals. In emergencies If no advance decision has been made or is known, CPR should be attempted unless: the patient has refused CPR; the patient is clearly in the terminal phase of illness; or the burdens of the treatment outweigh the benefits. Advance decision making Competent patients should be involved in discussions about attempting CPR unless they indicate that they do not want to be. Where patients lack competence to participate, people close to them can be helpful in reflecting their views. Legal issues Patients' rights under the Human Rights Act must be taken into account in decision making. Neither patients nor relatives can demand treatment which the health care team judges to be inappropriate, but all efforts will be made to accommodate wishes and preferences. In England, Wales and Northern Ireland relatives and people close to the patient are not entitled in law to take health care decisions for the patient. In Scotland, adults may appoint a health care proxy to give consent to medical treatment. Health professionals need to be aware of the law in relation to decision making for children and young people.IntroductionWhy policies are neededCardiopulmonary resuscitation can be attempted on any person whose cardiac or respiratory functions cease. Failure of these functions is part of dying and thus …. (shrink)

Introduction: The decision of “do not attempt resuscitation” in the event of cardiopulmonary arrest is usually made when the patients are critically ill and cannot make an informed choice. Although, various professional bodies have published guidelines, little is know about the patients’ own views regarding DNAR discussion.Aim: The aim of this study was to determine patients’ attitudes regarding discussing DNAR before they are critically ill.Methods: A prospective study was performed in a general out patients department. A questionnaire was distributed to (...) consecutive outpatients along with an explanatory leaflet in the adult outpatient clinic.Results: 364 patients completed the questionnaire . 90% of respondents wanted all patients to be asked regarding DNAR decision at some point during a hospital admission. The majority would not find a DNAR discussion distressing. Only 10% would find it upsetting, however, 48% of these still wanted a discussion. 37% of respondents wanted to discuss DNAR decisions on admission; 32% in outpatients; 17% at consent for surgery, 14% when they are critically ill. 87% of respondents would not object to their relatives being involved in making decisions about their resuscitation status. However, only 12% of the subjects in the study had been involved in discussing the resuscitation status of a relative and 21% would not be comfortable to discuss a relative’s resuscitation status. Although 33% of patients preferred their resuscitation status to simply be documented within their clinical notes, 77% wanted it to be more easily accessible.Conclusions: This study suggests that contrary to current practice most patients want to discuss their DNAR status prior to becoming critically ill. This includes half of the small number that find it distressing to discuss. Although most patients are comfortable with relatives being involved in discussing DNAR, a significant proportion do not want their relatives to be asked. Furthermore, once a decision has been made, the majority of patients want it to be more accessible than current practice allows. (shrink)

One less obvious impact of legal bilingualism in a postcolonial jurisdiction like Hong Kong is an increasing trend of unrepresented litigants. Since their lack of legal knowledge often places them at a disadvantage and poses numerous problems in court, the government has established the resource centre for unrepresented litigants to offer them information about legal procedure. This paper evaluates the usefulness of the Chinese official reference materials at the centre in equipping laymen for civil litigation. As a first point (...) of contact between unrepresented litigants and the law, these leaflets have a direct impact on the users’ understanding of litigation procedures and their courtroom performance. This paper argues that the leaflets suffer from two major problems: incomprehensibility of language and lack of structure. Problems involved in include inconsistency in terminology, problematic translation, and language complexity arising from the use of odd collocation, unusual words, difficult legal terminology and confusing parts of speech; whereas in , information is found to be scattered and disorganised. To improve readability, the paper suggests using plain language, and providing checklists of documents, and a legal glossary. Cross-jurisdiction practices will be examined to show how unrepresented litigants’ access to justice may be facilitated. (shrink)

Cette étude critique deux notions très répandues: 1° que les genes chromosomes forment les unités fondamentales du mécanisme biologique: 2° que les organismes sont des conséquences d'ensembles de genes ‘libres’.Il est suggéré que 3° l'information codée dans les chromosomes est plutôt comparable aux indications données par un livret d'instructions et que 4° des actions fondamentales des cellules ont pu précéder les instructions qui les concernent de même façon que les techniques humaines ont précédé des textes qui les analysent.Cette analogie (...) est élaborée en certains détails et quelquesunes de ses limitations sont demonstrées.In this paper two widely held ideas are criticized: that chromosomal genes are the fundamental units of biological machinery and that organisms have arisen from assemblies of “free” genes.Instead it is suggested that the information encoded in the chromosomes may better be compared with the instructions contained in a textbook or leaflet, an that basic cell activities may have preceded the instructions dealing with them in the same way in which human skills have preceded any texts dealing with them.This analogy is elaborated in certain details and some of its limitations are shown.Die Arbeit ist eine Kritik zweier weitverbreiteter Ideen, nämlich dass die Gene in den Chromosomen die fundamentalen Bestandteile der biologischen Maschinerie sind und dass die Organismen von Aggregaten „freier“ Gene abstammen.Statt dessen wird vorgeschlagen, dass die in den Chromosomen kodifizierte Information eher mit den Instruktionen eines Lehrbuchs oder einer Gebrauchsanweisung vergleichbar ist und dass die grundlegenden Zellaktivitäten früheren Ursprungs sein dürften, als die Instruktionen zu ihrer Ausführung, etwa in der Weise in der menschliche Fertigkeiten gedruckten Anweisungen zu ihrer Ausführung vorausgegangen sind.Verschiedene Einzelheiten dieser Analogie werden verfolgt und einige ihrer Grenzen aufgezeigt. (shrink)

Стаття розкриває питання інформаційної війни, яку проводили США та Велика Британія по відношенню до Німеччини. Зазначається, що для ведення інформаційної діяльності були створені спеціальні державні органи, які виконували різноманітні функції щодо забезпечення пропагандистської діяльності за кордоном. Акцентується на двох найбільш розповсюджених методах ведення інформаційної війни - використанні радіоефіру та поширенні листівок серед військових та місцевого населення.

The Editors express their gratitude and appreciation to the indi-viduals listed below who served as referees for Informal Logic for Volumes 31 (2011) and 32 (2012).

The plan for this volume emerged during the international Leipzig conference commemorating the centenary of the death of Gustav Fechner.

Information theory and statistical mechanics II.

The papers collected in this volume exemplify some of the trends in current approaches to logic, language and computation. Written by authors with varied academic backgrounds, the contributions are intended for an interdisciplinary audience. The first part of this volume addresses issues relevant for multi-agent systems: reasoning with incomplete information, reasoning about knowledge and beliefs, and reasoning about games. Proofs as formal objects form the subject of Part II. Topics covered include: contributions on logical frameworks, linear logic, and different (...) approaches to formalized reasoning. Part III focuses on representations and formal methods in linguistic theory, addressing the areas of comparative and temporal expressions, modal subordination, and compositionality. (shrink)

Top-down feedback does not benefit speech recognition; on the contrary, it can hinder it. No experimental data imply that feedback loops are required for speech recognition. Feedback is accordingly unnecessary and spoken word recognition is modular. To defend this thesis, we analyse lexical involvement in phonemic decision making. TRACE (McClelland & Elman 1986), a model with feedback from the lexicon to prelexical processes, is unable to account for all the available data on phonemic decision making. The modular Race model (Cutler (...) & Norris 1979) is likewise challenged by some recent results, however. We therefore present a new modular model of phonemic decision making, the Merge model. In Merge, information flows from prelexical processes to the lexicon without feedback. Because phonemic decisions are based on the merging of prelexical and lexical information, Merge correctly predicts lexical involvement in phonemic decisions in both words and nonwords. Computer simulations show how Merge is able to account for the data through a process of competition between lexical hypotheses. We discuss the issue of feedback in other areas of language processing and conclude that modular models are particularly well suited to the problems and constraints of speech recognition. Key Words: computational modeling; feedback; lexical processing; modularity; phonemic decisions; reading; speech recognition; word recognition. (shrink)

We report on our experiences in a participatory design project to develop ICTs in a hospital ward working with deliberate self-harm patients. This project involves the creation and constant re-creation of socio-technical ensembles that satisfy the various, changing and often contradictory and conflicting needs in this context. Such systems are shaped in locally meaningful ways but nevertheless reach beyond their immediate context to gain wider importance and to be integrated with the larger environment.

Many theorists have dismissed a priori the idea that distributional information could play a significant role in syntactic category acquisition. We demonstrate empirically that such information provides a powerful cue to syntactic category membership, which can be exploited by a variety of simple, psychologically plausible mechanisms. We present a range of results using a large corpus of child‐directed speech and explore their psychological implications. While our results show that a considerable amount of information concerning the syntactic categories (...) can be obtained from distributional information alone, we stress that many other sources of information may also be potential contributors to the identification of syntactic classes. (shrink)