Before it was 10 minutes old, a human neonate was able to turn its eyes in the direction of an auditory stimulus. This demonstrates that learning is not essential for a crude form of auditory localization, directional oculomotor response, and coordination of auditory and visual functioning.

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In an effort to understand some of the functional determinants of naming, Koehler's maluma-takete demonstration was examined in two studies, to see whether the matching of the nonsense words and nonsense figures could be accounted for on the basis of physiognomic similarity, as measured by the semantic differential. Matching was found to occur overwhelmingly in the expected direction, and the similarity of semantic differential locations of matched pairs was far greater than that of non-matched pairs. This held strikingly for “literal” scales (such as “Angular-Rounded”) but also held to a lesser extent for clearly “non-literal” scales (such as “Fresh-Stale”), indicating that physiognomic properties over and beyond simple literal description of the stimuli were involved. Study of the semantic differential locations of letters composing the nonsense words, and of ratings of the “fittingness” of the letters as names for the nonsense figures, showed that the physiognomic similarity presumably mediating the naming phenomenon may, at least in the Koehler demonstration, reside in the individual letters rather than in some emergent quality of the whole word. All in all, the study attempted to go beyond just checking whether a “fittingness” phenomenon occurs in naming, by exploring processes hypothesized to underlie the “fittingness.” In at least some cases, physiognomic similarity may be the psychological process mediating naming.

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BACKGROUND There are limited data explaining why women ≥80 years receive less aggressive treatment for breast cancer than younger women. OBJECTIVES To identify factors that influence women aged 80 and older’s breast cancer treatment decisions. DESIGN Medical record review. SETTING One academic primary care clinic and two community health centers in Boston. PARTICIPANTS 65 women aged ≥80 years diagnosed with breast cancer between 1994–2004 and followed through 6/30/2010. MEASUREMENTS We abstracted data on breast cancer characteristics, comorbidities, treatments received, and outcomes. We reviewed notes from primary care physicians, oncologists, and breast surgeons to determine factors involved in treatment decision-making. RESULTS Median age at diagnosis was 84.0 years (interquartile range 82.0–86.3); 84.6% (n=55) were non-Hispanic white; and 61.5% (n=40) had at least one comorbidity. Nine women were diagnosed with ductal carcinoma in situ, 42 with a new primary invasive breast cancer, 8 with a second primary, and 6 with a breast cancer recurrence. Sixty-three (96.9%) received some type of treatment. Fifty-six (86.2%) had at least one detailed physician note on treatment decision-making in their chart. The main categories found to influence patient, family, and physician treatment decision-making were: tumor characteristics, the ratio of treatment benefits to risks, logistics (e.g. transportation, finances), and patient age, health (including a concurrent diagnosis), and psychosocial characteristics. Family was involved in treatment discussions for 46 (70.8%) patients. CONCLUSION The quality of physician documentation about decision-making in these women was quite high. A great deal of thoughtful and complex decision-making involving patients, family, and physicians is noted to occur after a woman ≥80 years is diagnosed with breast cancer.

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