Repair Avoidance: When Faithful Informational Exchanges Don't Matter That Much

Common-sense intuition suggests that, when people are engaged in informational exchanges, they communicate so as to be reasonably sure that they perform the exchanges faithfully. Over the years, we have found evidence suggesting that this intuition, which is woven into several influential theories of human communication, may be misleading. We first summarize this evidence and discuss its potential limitations. Then, we present a new study that addresses the potential limitations. A confederate instructed participants to "pick up the skask" from a tray containing six objects and move it to a specific location. Since skask is a non-word invented by us, participants had to ask for clarification to perform the instruction faithfully. In contradiction with the intuition that people pursue faithfulness when engaged in informational exchanges, 29 of the 48 participants we tested performed the instruction without asking for clarification. We identified a possible cause for this behavior, which occurred more frequently when avoiding the clarification was unlikely to result in an overt consequence (an error in the execution of the instruction that could be noticed by the confederate or the experimenter). Other factors such as individual differences and the specific interpersonal dynamics of the experimental settings, if they played a role at all, did it to an extent that is unlikely to be comparable to that of the role played by overt consequences. Considered together, our various assessments of the extent to which people engage in faithful informational exchanges converge on a simple conclusion: Communicating faithfully is a substantially demanding task, and people often fail at it. We discuss the implications of this conclusion and speculate on its relevance for understanding the evolutionary past of human communication.

Tetralogy of Fallot: an overview, case report, and discussion of dental implications

Tetralogy of Fallot (TOF) is the most common cause of cyanotic heart disease. The anatomic defects comprising TOF lead to the systemic circulation of oxygen-poor (desaturated) blood, resulting in symptoms of cyanosis, polycythemia, and hypoxia. Untreated, most patients with this disorder die during childhood. Surgical treatment aimed at correcting the defects is currently recommended for infants. Long-term studies have reported good results with this approach. The case history of a four-year-old male with uncorrected tetralogy of Fallot is presented. The patient required extensive dental treatment prior to scheduled cardiac catheterization. The dental findings and plan of care for this patient are detailed, and attention is given to the role of the medical work-up, preoperative antibiotics, and sedatives. It is stressed that the dental treatment plan for patients with tetralogy of Fallot must take into account the patients' medical status both prior to and following corrective surgical procedures.

Stevens-Johnson syndrome in an HIV-infected patient

Stevens-Johnson syndrome (SJS) is a severe and sometimes lethal form of erythema multiforme most often associated with a drug hypersensitivity reaction. HIV-infected patients suffer a higher incidence of SJS than the general population. This article details a case of nevirapine-induced SJS in an HIV-seropositive man and reviews the clinical features of erythema multiforme, SJS, and their association with drugs commonly used in the treatment of HIV infection.