The Gestalt psychologists reported a set of laws describing how vision groups elements to recognize objects. The Gestalt laws “prescribe for us what we are to recognize ‘as one thing’” (Köhler, 1920). Were they right? Does object recognition involve grouping? Tests of the laws of grouping have been favourable, but mostly assessed only detection, not identification, of the compound object. The grouping of elements seen in the detection experiments with lattices and “snakes in the grass” is compelling, but falls far short of the vivid everyday experience of recognizing a familiar, meaningful, named thing, which mediates the ordinary identification of an object. Thus, after nearly a century, there is hardly any evidence that grouping plays a role in ordinary object recognition. To assess grouping in object recognition, we made letters out of grating patches and measured threshold contrast for identifying these letters in visual noise as a function of perturbation of grating orientation, phase, and offset. We define a new measure, “wiggle”, to characterize the degree to which these various perturbations violate the Gestalt law of good continuation. We find that efficiency for letter identification is inversely proportional to wiggle and is wholly determined by wiggle, independent of how the wiggle was produced. Thus the effects of three different kinds of shape perturbation on letter identifiability are predicted by a single measure of goodness of continuation. This shows that letter identification obeys the Gestalt law of good continuation and may be the first confirmation of the original Gestalt claim that object recognition involves grouping.
Gestalt; Grouping; Contour integration; Good continuation; Letter identification; Object recognition; Features; Snake in the grass; Snake letters; Dot lattice
The human visual system is highly sensitive to biological motion and manages to organize even a highly reduced point-light stimulus into a vivid percept of human action. The current study investigated to what extent the origin of this saliency of point-light displays is related to its intrinsic Gestalt qualities. In particular, we studied whether biological motion perception is facilitated when the elements can be grouped according to good continuation and similarity as Gestalt principles of perceptual organization. We found that both grouping principles enhanced biological motion perception but their effects differed when stimuli were inverted. These results provide evidence that Gestalt principles of good continuity and similarity also apply to more complex and dynamic meaningful stimuli.
Binding of features helps object recognition in contour integration, but hinders it in crowding. In contour integration, aligned adjacent objects group together to form a path. In crowding, flanking objects make the target unidentifiable. But, to date, the two tasks have only been studied separately. May and Hess (2007) suggested that the same binding mediates both tasks. To test this idea, we ask observers to perform two different tasks with the same stimulus. We present oriented grating patches that form a “snake letter” in the periphery. Observers report either the identity of the whole letter (contour integration task) or the phase of one of the grating patches (crowding task). We manipulate the strength of binding between gratings by varying the alignment between them, i.e. the Gestalt goodness of continuation, measured as “wiggle”. We find that better alignment strengthens binding, which improves contour integration and worsens crowding. Observers show equal sensitivity to alignment in these two very different tasks, suggesting that the same binding mechanism underlies both phenomena. It has been claimed that grouping among flankers reduces their crowding of the target. Instead, we find that these published cases of weak crowding are due to weak binding resulting from target-flanker misalignment. We conclude that crowding is mediated solely by the grouping of flankers with the target and is independent of grouping among flankers.
crowding; wiggle; grouping; binding; Gestalt; contour integration; good continuation; alignment; object recognition; snake letter
While early and higher visual areas along the ventral visual pathway in the inferotemporal cortex are critical for the recognition of individual objects, the neural representation of human perception of complex global visual scenes remains under debate. Stroke patients with a selective deficit in the perception of a complex global Gestalt with intact recognition of individual objects – a deficit termed simultanagnosia – greatly helped to study this question. Interestingly, simultanagnosia typically results from bilateral lesions of the temporo-parietal junction (TPJ). The present study aimed to verify the relevance of this area for human global Gestalt perception. We applied continuous theta-burst TMS either unilaterally (left or right) or bilateral simultaneously over TPJ. Healthy subjects were presented with hierarchically organized visual stimuli that allowed parametrical degrading of the object at the global level. Identification of the global Gestalt was significantly modulated only for the bilateral TPJ stimulation condition. Our results strengthen the view that global Gestalt perception in the human brain involves TPJ and is co-dependent on both hemispheres.
Autism narratives are not just stories or histories, describing a given reality. They are creating the language in which to describe the experience of autism, and hence helping to forge the concepts in which to think autism. This paper focuses on a series of autobiographies that began with Grandin's Emergence. These are often said to show us autism from the ‘inside’. The paper proposes that instead they are developing ways to describe experience for which there is little pre-existing language. Wittgenstein has many well-known aphorisms about how we understand other people directly, without inference. They condense what he had found in Wolfgang Köhler's Gestalt Psychology. These phenomena of direct understanding what other people are doing are, Köhler wrote, ‘the common property and practice of mankind'. They are not the common property and practice of people with autism. Ordinary language is rich in age-old ways to describe what others are thinking, feeling and so forth. Köhler's phenomena are the bedrock on which such language rests. There is no such discourse for autism, because Köhler's phenomena are absent. But a new discourse is being made up right now, i.e. ways of talking for which the autobiographies serve as working prototypes.
Köhler; Wittgenstein; Grandin; Donna Williams; Mukhopadhyay; Tammet
To the naïve observer, cubist paintings contain geometrical forms in which familiar objects are hardly recognizable, even in the presence of a meaningful title. We used fMRI to test whether a short training session about Cubism would facilitate object recognition in paintings by Picasso, Braque and Gris. Subjects, who had no formal art education, were presented with titled or untitled cubist paintings and scrambled images, and performed object recognition tasks. Relative to the control group, trained subjects recognized more objects in the paintings, their response latencies were significantly shorter, and they showed enhanced activation in the parahippocampal cortex, with a parametric increase in the amplitude of the fMRI signal as a function of the number of recognized objects. Moreover, trained subjects were slower to report not recognizing any familiar objects in the paintings and these longer response latencies were correlated with activation in a fronto-parietal network. These findings suggest that trained subjects adopted a visual search strategy and used contextual associations to perform the tasks. Our study supports the proactive brain framework, according to which the brain uses associations to generate predictions.
cognition; fMRI; learning; object recognition; parahippocampal cortex; plasticity
In 1912, Max Wertheimer published his paper on phi motion, widely recognized as the start of Gestalt psychology. Because of its continued relevance in modern psychology, this centennial anniversary is an excellent opportunity to take stock of what Gestalt psychology has offered and how it has changed since its inception. We first introduce the key findings and ideas in the Berlin school of Gestalt psychology, and then briefly sketch its development, rise, and fall. Next, we discuss its empirical and conceptual problems, and indicate how they are addressed in contemporary research on perceptual grouping and figure-ground organization. In particular, we review the principles of grouping, both classical (e.g., proximity, similarity, common fate, good continuation, closure, symmetry, parallelism) and new (e.g., synchrony, common region, element and uniform connectedness), and their role in contour integration and completion. We then review classic and new image-based principles of figure-ground organization, how it is influenced by past experience and attention, and how it relates to shape and depth perception. After an integrated review of the neural mechanisms involved in contour grouping, border-ownership, and figure-ground perception, we conclude by evaluating what modern vision science has offered compared to traditional Gestalt psychology, whether we can speak of a Gestalt revival, and where the remaining limitations and challenges lie. A better integration of this research tradition with the rest of vision science requires further progress regarding the conceptual and theoretical foundations of the Gestalt approach, which will be the focus of a second review paper.
Gestalt; grouping principles; figure-ground organization; neural mechanisms; vision science
Multiple stimuli that are present simultaneously in the visual field compete for neural representation. At the same time, however multiple stimuli in cluttered scenes also undergo perceptual organization according to certain rules originally defined by the Gestalt psychologists such as similarity or proximity, thereby segmenting scenes into candidate objects. How can these two seemingly orthogonal neural processes that occur early in the visual processing stream be reconciled? One possibility is that competition occurs among perceptual groups, rather than at the level of elements within a group. We probed this idea using fMRI by assessing competitive interactions across visual cortex in displays containing varying degrees of perceptual organization, or perceptual grouping (Grp). In strong Grp displays, elements were arranged such that either an illusory figure or a group of collinear elements were present, while in weak Grp displays the same elements were arranged randomly. Competitive interactions among stimuli were overcome throughout early visual cortex and V4, when elements were grouped regardless of Grp type. Our findings suggest that context-dependent grouping mechanisms and competitive interactions are linked to provide a bottom-up bias towards candidate objects in cluttered scenes.
The visual system groups similar features, objects, and motion (e.g., Gestalt grouping). Recent work suggests that the computation underlying perceptual grouping may be one of summary statistical representation. Summary representation occurs for low-level features, such as size, motion, and position, and even for high level stimuli, including faces; for example, observers accurately perceive the average expression in a group of faces (J. Haberman & D. Whitney, 2007, 2009). The purpose of the present experiments was to characterize the time-course of this facial integration mechanism. In a series of three experiments, we measured observers’ abilities to recognize the average expression of a temporal sequence of distinct faces. Faces were presented in sets of 4, 12, or 20, at temporal frequencies ranging from 1.6 to 21.3 Hz. The results revealed that observers perceived the average expression in a temporal sequence of different faces as precisely as they perceived a single face presented repeatedly. The facial averaging was independent of temporal frequency or set size, but depended on the total duration of exposed faces, with a time constant of ~800 ms. These experiments provide evidence that the visual system is sensitive to the ensemble characteristics of complex objects presented over time.
vision; perception; face; object recognition; temporal integration; texture; spatial vision
Unstructured proteins, RNA or DNA components provide functionally important flexibility that is key to many macromolecular assemblies throughout cell biology. As objective, quantitative experimental measures of flexibility and disorder in solution are limited, small angle scattering (SAS), and in particular small angle X-ray scattering (SAXS), provides a critical technology to assess macromolecular flexibility as well as shape and assembly. Here, we consider the Porod-Debye law as a powerful tool for detecting biopolymer flexibility in SAS experiments. We show that the Porod-Debye region fundamentally describes the nature of the scattering intensity decay, which captures information needed for distinguishing between folded and flexible particles. Particularly for comparative SAS experiments, application of the law, as described here, can distinguish between discrete conformational changes and localized flexibility relevant to molecular recognition and interaction networks. This approach aids insightful analyses of fully and partly flexible macromolecules that is more robust and conclusive than traditional Kratky analyses. Furthermore, we demonstrate for prototypic SAXS data that the ability to calculate particle density by the Porod-Debye criteria, as shown here, provides an objective quality assurance parameter that may prove of general use for SAXS modeling and validation.
Study objective: In the United Kingdom, recognition of the links between social and health problems has led to government initiatives such as health action zones. The principles of civil law apply to many types of social problem, and the civil justice system provides one means through which they can be tackled. However, little research has been undertaken into the particular links between problems to which civil legal principles and processes can be applied and morbidity. This study examines these links, and the role of legal advice and services in preventing ill health.
Design: This study examined survey respondents' self reports of longstanding illness/disability and experience of 18 problems to which legal principles can be applied.
Setting: A random national survey conducted across England and Wales.
Participants: 5611 adults drawn from 3348 residential households.
Main results: Significant associations were found between illness/disability and 13 of the problem types. Moreover, experience of greater numbers of problems increased the likelihood of reported illness/disability. In attempting to resolve problems respondents' health also frequently suffered.
Conclusions: This study highlights the contribution that public legal education and legal advice can make to the promotion of public health, and the importance of further integration of health and civil justice initiatives through health action zones, community legal service partnerships, etc, to further this end.
On average, less than 8% of people who experience an out-of-hospital cardiac arrest survive. However, death from sudden cardiac arrest is preventable if a bystander quickly retrieves and applies an automated external defibrillator (AED). Public access defibrillation (PAD) policies have been enacted to create programs that increase the public availability of these devices. The objective of this study was to describe each state's legal requirements for recommended PAD program elements.
We reviewed state laws and described the extent to which 13 PAD program elements are mandated in each state.
No jurisdiction requires all 13 PAD program elements, 18% require at least 10 elements, and 31% require 3 or fewer elements. All jurisdictions provide some level of immunity to AED users, 60% require PAD maintenance, 59% require emergency medical service notification, 55% impose training requirements, and 41% require medical oversight. Few jurisdictions require a quality improvement process.
PAD programs in many states are at risk of failure because critical elements such as maintenance, medical oversight, emergency medical service notification, and continuous quality improvement are not required. Policy makers should consider strengthening PAD policies by enacting laws that can reduce the time from collapse to shock, such as requiring the strategic placement of AEDs in high-risk locations or mandatory PAD registries that are coordinated with local EMS and dispatch centers. Further research is needed to identify the most effective PAD policies for increasing AED use by lay persons and improving survival rates.
In many sliding systems consisting of solid object on a solid substrate under dry condition, the friction force does not depend on the apparent contact area and is proportional to the loading force. This behaviour is called Amontons' law and indicates that the friction coefficient, or the ratio of the friction force to the loading force, is constant. Here, however, using numerical and analytical methods, we show that Amontons' law breaks down systematically under certain conditions for an elastic object experiencing a friction force that locally obeys Amontons' law. The macroscopic static friction coefficient, which corresponds to the onset of bulk sliding of the object, decreases as pressure or system length increases. This decrease results from precursor slips before the onset of bulk sliding, and is consistent with the results of certain previous experiments. The mechanisms for these behaviours are clarified. These results will provide new insight into controlling friction.
This study is planned to determine the neurocognitive difficulties of hydrocephalic adults.
The research group contained healthy adults (control group, n : 15), and hydrocephalic adults (n : 15). Hydrocephalic group consisted of patients with idiopathic aquaduct stenosis and post-meningitis hydrocephalus. All patients were followed with shunted hydrocephalus and not gone to shunt revision during last two years. They were chosen from either asymptomatic or had only minor symptoms without motor and sensorineural deficit. A neuropsychological test battery (Raven Standart Progressive Matrices, Bender-Gestalt Test, Cancellation Test, Clock Drawing Test, Facial Recognition Test, Line Orientation Test, Serial Digit Learning Test, Stroop Color Word Interference Test-TBAG Form, Verbal Fluency Test, Verbal Fluency Test, Visual-Aural Digit Span Test-B) was applied to all groups.
Neuropsychological assessment of hydrocephalic patients demonstrated that they had poor performance on visual, semantic and working memory, visuoconstructive and frontal functions, reading, attention, motor coordination and executive function of parietal lobe which related with complex and perseverative behaviour. Eventually, these patients had significant impairment on the neurocognitive functions of their frontal, parietal and temporal lobes. On the other hand, the statistical analyses performed on demographic data showed that the aetiology of the hydrocephalus, age, sex and localization of the shunt (frontal or posterior parietal) did not affect the test results.
This prospective study showed that adult patients with hydrocephalus have serious neuropsychological problems which might be directly caused by the hydrocephalus; and these problems may cause serious adaptive difficulties in their social, cultural, behavioral and academic life.
Adult; Hydrocephalus; Neuropsychological assessment
Dual-process theory hypothesizes that recognition memory depends on two distinguishable memory signals. Recollection reflects conscious recovery of detailed information about the learning episode. Familiarity reflects a memory signal that is not accompanied by a vivid conscious experience but nonetheless enables participants to distinguish recently-experienced probe items from novel ones. This dual-process explanation of recognition memory has gained wide acceptance among cognitive neuroscientists and some cognitive psychologists. Nonetheless, its difficulty in providing a quantitatively satisfactory description of performance in item recognition experiments has precluded a consensus not only about the theoretical structure of recognition memory but also about how to best measure recognition accuracy. In two experiments we show that neither the standard formulation of dual-process signal detection theory (DPSD) nor a widely-used single-process model (UVSD) provides a satisfactory explanation of recognition memory across different types of study materials (words and travel scenes). In the variable recollection dual-process model (VRDP), recollection fails for some old probe items, as in standard formulations of dual process signal detection theory, but gives rise to a continuous distribution of memory strengths when it succeeds. The VRDP can approximate both the DPSD and the UVSD. In both experiments it provides a consistently superior fit across materials to the superset of the DPSD and UVSD. The VRDP offers a simple explanation of the form of conjoint item-source judgments, something neither the DPSD nor the UVSD can accomplish. The success of the VRDP supports the core assumptions of dual-process theory by providing an excellent quantitative description of recognition performance across materials, response criteria and type of response.
That shape is important for perception has been known for almost a thousand years (thanks to Alhazen in 1083) and has been a subject of study ever since by scientists and phylosophers (such as Descartes, Helmholtz or the Gestalt psychologists). Shapes are important object descriptors. If there was any remote doubt regarding the importance of shape, recent experiments have shown that intermediate areas of primate visual cortex such as V2, V4 and TEO are involved in analyzing shape features such as corners and curvatures. The primate brain appears to perform a wide variety of complex tasks by means of simple operations. These operations are applied across several layers of neurons, representing increasingly complex, abstract intermediate processing stages. Recently, new models have attempted to emulate the human visual system. However, the role of intermediate representations in the visual cortex and their importance have not been adequately studied in computational modeling.
This paper proposes a model of shape-selective neurons whose shape-selectivity is achieved through intermediate layers of visual representation not previously fully explored. We hypothesize that hypercomplex - also known as endstopped - neurons play a critical role to achieve shape selectivity and show how shape-selective neurons may be modeled by integrating endstopping and curvature computations. This model - a representational and computational system for the detection of 2-dimensional object silhouettes that we term 2DSIL - provides a highly accurate fit with neural data and replicates responses from neurons in area V4 with an average of 83% accuracy. We successfully test a biologically plausible hypothesis on how to connect early representations based on Gabor or Difference of Gaussian filters and later representations closer to object categories without the need of a learning phase as in most recent models.
To determine whether Lexington, Kentucky's smoke‐free law affected employment and business closures in restaurants and bars. On 27 April 2004, Lexington‐Fayette County implemented a comprehensive ordinance prohibiting smoking in all public buildings, including bars and restaurants. Lexington is located in a major tobacco‐growing state that has the highest smoking rate in the US and was the first Kentucky community to become smoke‐free.
A fixed‐effects time series design to estimate the effect of the smoke‐free law on employment and ordinary least squares to estimate the effect on business openings and closings.
Subjects and settings
All restaurants and bars in Lexington‐Fayette County, Kentucky and the six contiguous counties.
Main outcome measures
ES‐202 employment data from the Kentucky Workforce Cabinet; Business opening/closings data from the Lexington‐Fayette County Health Department, Environmental Division.
A positive and significant relationship was observed between the smoke‐free legislation and restaurant employment, but no significant relationship was observed with bar employment. No relationship was observed between the law's implementation and employment in contiguous counties nor between the smoke‐free law and business openings or closures in alcohol‐serving and or non‐alcohol‐serving businesses.
No important economic harm stemmed from the smoke‐free legislation over the period studied, despite the fact that Lexington is located in a tobacco‐producing state with higher‐than‐average smoking rates.
The process of perception requires not only the brain's receipt of sensory data but also the meaningful organization of that data in relation to the perceptual experience held in memory. Although it typically results in a conscious percept, the process of perception is not fully conscious. Research on the neural substrates of human visual perception has suggested that regions of limbic cortex, including the medial orbital frontal cortex (mOFC), may contribute to intuitive judgments about perceptual events, such as guessing whether an object might be present in a briefly presented fragmented drawing. Examining dense array measures of cortical electrical activity during a modified Waterloo Gestalt Closure Task, results show, as expected, that activity in medial orbital frontal electrical responses (about 250 ms) was associated with intuitive judgments. Activity in the right temporal-parietal-occipital (TPO) region was found to predict mOFC (∼150 ms) activity and, in turn, was subsequently influenced by the mOFC at a later time (∼300 ms). The initial perception of gist or meaning of a visual stimulus in limbic networks may thus yield reentrant input to the visual areas to influence continued development of the percept. Before perception is completed, the initial representation of gist may support intuitive judgments about the ongoing perceptual process.
The predominant view of motion and form processing in the human visual system assumes that these two attributes are handled by separate and independent modules. Motion processing involves filtering by direction-selective sensors, followed by integration to solve the aperture problem. Form processing involves filtering by orientation-selective and size-selective receptive fields, followed by integration to encode object shape. It has long been known that motion signals can influence form processing in the well-known Gestalt principle of common fate; texture elements which share a common motion property are grouped into a single contour or texture region. However, recent research in psychophysics and neuroscience indicates that the influence of form signals on motion processing is more extensive than previously thought. First, the salience and apparent direction of moving lines depends on how the local orientation and direction of motion combine to match the receptive field properties of motion-selective neurons. Second, orientation signals generated by “motion-streaks” influence motion processing; motion sensitivity, apparent direction and adaptation are affected by simultaneously present orientation signals. Third, form signals generated by human body shape influence biological motion processing, as revealed by studies using point-light motion stimuli. Thus, form-motion integration seems to occur at several different levels of cortical processing, from V1 to STS.
motion sensitivity; motion-streaks; motion perception; motion-form interactions; biological motion
The ability to identify letters and encode their position is a crucial step of the word recognition process. However and despite their word identification problem, the ability of dyslexic children to encode letter identity and letter-position within strings was not systematically investigated. This study aimed at filling this gap and further explored how letter identity and letter-position encoding is modulated by letter context in developmental dyslexia. For this purpose, a letter-string comparison task was administered to French dyslexic children and two chronological age (CA) and reading age (RA)-matched control groups. Children had to judge whether two successively and briefly presented four-letter strings were identical or different. Letter-position and letter identity were manipulated through the transposition (e.g., RTGM vs. RMGT) or substitution of two letters (e.g., TSHF vs. TGHD). Non-words, pseudo-words, and words were used as stimuli to investigate sub-lexical and lexical effects on letter encoding. Dyslexic children showed both substitution and transposition detection problems relative to CA-controls. A substitution advantage over transpositions was only found for words in dyslexic children whereas it extended to pseudo-words in RA-controls and to all type of items in CA-controls. Letters were better identified in the dyslexic group when belonging to orthographically familiar strings. Letter-position encoding was very impaired in dyslexic children who did not show any word context effect in contrast to CA-controls. Overall, the current findings point to a strong letter identity and letter-position encoding disorder in developmental dyslexia.
letter-string processing; letter-position encoding; letter-identity encoding; letter transposition; letter substitution; reading acquisition; dyslexic children
1. A study of the historical development of the Weber-Fechner law shows that it fails to describe intensity perception; first, because it is based on observations which do not record intensity discrimination accurately, and second, because it omits the essentially discontinuous nature of the recognition of intensity differences. 2. There is presented a series of data, assembled from various sources, which proves that in the visual discrimination of intensity the threshold difference ΔI bears no constant relation to the intensity I. The evidence shows unequivocally that as the intensity rises, the ratio See PDF for Equation first decreases and then increases. 3. The data are then subjected to analysis in terms of a photochemical system already proposed for the visual activity of the rods and cones. It is found that for the retinal elements to discriminate between one intensity and the next perceptible one, the transition from one to the other must involve the decomposition of a constant amount of photosensitive material. 4. The magnitude of this unitary increment in the quantity of photochemical action is greater for the rods than for the cones. Therefore, below a certain critical illumination—the cone threshold—intensity discrimination is controlled by the rods alone, but above this point it is determined by the cones alone. 5. The unitary increments in retinal photochemical action may be interpreted as being recorded by each rod and cone; or as conditioning the variability of the retinal cells so that each increment involves a constant increase in the number of active elements; or as a combination of the two interpretations. 6. Comparison with critical data of such diverse nature as dark adaptation, absolute thresholds, and visual acuity shows that the analysis is consistent with well established facts of vision.
Amblyopia is a developmental abnormality that results in deficits for a wide range of visual tasks, most notably, the reduced ability to see fine details, the loss in contrast sensitivity especially for small objects and the difficulty in seeing objects in clutter (crowding). The primary goal of this study was to evaluate whether crowding can be ameliorated in adults with amblyopia through perceptual learning using a flanked letter identification task that was designed to reduce crowding, and if so, whether the improvements transfer to untrained visual functions: visual acuity, contrast sensitivity and the size of visual span (the amount of information obtained in one fixation). To evaluate whether the improvements following this training task were specific to training with flankers, we also trained another group of adult observers with amblyopia using a single letter identification task that was designed to improve letter contrast sensitivity, not crowding. Following 10,000 trials of training, both groups of observers showed improvements in the respective training task. The improvements generalized to improved visual acuity, letter contrast sensitivity, size of the visual span, and reduced crowding. The magnitude of the improvement for each of these measurements was similar in the two training groups. Perceptual learning regimens aimed at reducing crowding or improving letter contrast sensitivity are both effective in improving visual acuity, contrast sensitivity for near-acuity objects and reducing the crowding effect, and could be useful as a clinical treatment for amblyopia.
An analyst has to display all the patience and
tolerance and reliability of a mother devoted
to her infant, has to recognize the patient’s
wishes as needs, has to put aside other interests in order to be available and to be punctual, and objective, and has to seem to want
to give what is really only given because of the
There may be a long initial period in
which the analyst’s point of view cannot be
(even unconsciously) appreciated by the patient. Acknowledgment cannot be expected
because at the primitive root of the patient
that is being looked for there is no capacity
for identification with the analyst, and certainly the patient cannot see that the analyst’s
hate is often engendered by the very things
the patient does in his crude way of loving.
In the analysis (research analysis) or in
ordinary management of the more psychotic
type of patient, a great strain is put on the
analyst (psychiatrist, mental nurse) and it is
important to study the ways in which anxiety
of psychotic quality and also hate are produced in those who work with severely ill
psychiatric patients. Only in this way can
there be any hope of the avoidance of therapy
that is adapted to the needs of the therapist
rather than to the needs of the patient.
Background and objective
British American Tobacco (BAT) has historically enjoyed a monopoly position in Kenya. Analysis of recent tobacco control debates and a case study of BAT's response to the emergence of competition in Kenya are used to explore the company's ability to shape public policy and its treatment of tobacco farmers.
Analysis of internal industry documents from BAT's Guildford depository, other relevant data and interviews with key informants.
BAT enjoys extensive high‐level political connections in Kenya, including close relationships with successive Kenyan presidents. Such links seems to have been used to influence public policy. Health legislation has been diluted and delayed, and when a competitor emerged in the market, BAT used its contacts to have the government pass legislation drafted by BAT that compelled farmers to sell tobacco to BAT rather than to its competitor. BAT was already paying farmers less than any other African leaf‐growing company, and the legislation entrenched poor pay and a quasi‐feudal relationship. BAT's public relation's response to the threat of competition and the ministers' public statements extolling the economic importance of tobacco growing suggest that BAT has manipulated tobacco farming as a political issue.
The extent of BAT's influence over public policy is consistent with the observations that, despite ratifying the Framework Convention on Tobacco Control, progress in implementing tobacco control measures in Kenya has been limited. The benefits of tobacco farming seem to be deliberately exaggerated, and an analysis of its true cost benefits is urgently needed. Tobacco farmers must be protected against BAT's predatory practices and fully informed about its activities to help them have an informed role in policy debates. As image, particularly around the importance of tobacco farming, seems key to BAT's ability to influence policy, the truth about its treatment of farmers must be publicised.
The Frank–Starling law describes the relation between left ventricular volume and function. However, only a few studies have described the relation between left atrial volume (LAV) and function.
To describe an LA Frank–Starling law by studying changes in LAV measured by real‐time, three‐dimensional echocardiography (RT3DE).
LAV was calculated by RT3DE in 70 patients at end‐systole (LAVmax), end‐diastole (LAVmin) and pre‐atrial contraction (LAVpre‐A). According to LAVmax, patients were classified into three groups: LAVmax <50 ml (group I), LAVmax 50–70 ml (group II) and LAVmax >70 ml (group III). Calculated indices of LA pump function were active atrial stroke volume (SV), defined as LAVpre‐A – LAVmin, and active atrial emptying fraction (EF), defined as active atrial SV/LAVpre‐A ×100%
Active atrial SV was significantly higher in group II than in group I (mean (SD) 19.0 (9.2) vs 8.2 (4.9) ml, p<0.0001), in group III it was non‐significantly lower than in group II (16.7 (12.5) vs 19.0 (9.2) ml). Active atrial SV correlated well with LAVpre‐A (r = 0.56, p<0.001), but decreased with larger LAVpre‐A. Active atrial EF tended to be higher in group II than in group I (43.1 (18.2) vs 33.2 (17.5), p<0.10), in group III it was significantly lower than in group II (26.2 (18.5) vs 43.1 (18.2), p<0.01).
A Frank–Starling mechanism in the left atrium could be described by RT3DE, shown by an increase in LA contractility in response to an increase in LA preload up to a point, beyond which LA contractility decreased.
left atrial volume; left atrial function; Starling mechanism; real‐time; three‐dimensional echocardiography