Fabrizio Calzavarini

Key Points The cognitive science of human decision making suggests a novel kind of approach to modifying people’s behavior: nudging. A nudge intervention implies a non-coercive and typically small change of the choice context that exploits inherent tendencies of agents in order to promote beneficial outcomes. Studies show that—if properly motivated, devised, and tested—nudges can improve practice in internal and emergency medicine facilities. Nudge interventions are not meant to displace more traditional tools to promote beneficial behavior (training, regulations), but to combine with them.

Hand hygiene among professionals plays a crucial role in preventing healthcare‐associated infections, yet poor compliance in hospital settings remains a lasting reason for concern. Nudge theory is an innovative approach to behavioral change first developed in economics and cognitive psychology, and recently spread and discussed in clinical medicine. To assess a combined nudge intervention (localized dispensers, visual reminders, and gain-framed posters) to promote hand hygiene compliance among hospital personnel. A quasi-experimental study including a pre-intervention phase and a post-intervention phase (9 + 9 consecutive months) with 117 professionals overall from three wards in a 350-bed general city hospital. Hand hygiene compliance was measured using direct observations by trained personnel and measurement of alcohol-based hand-rub consumption. Levels of hand hygiene compliance were low in the pre-intervention phase: 11.44% of hand hygiene opportunities prescribed were fulfilled overall. We observed a statistically significant effect of the nudge intervention with an increase to 18.71% (p < 0.001) in the post-intervention phase. Improvement was observed in all experimental settings (the three hospital wards). A statistical comparison across three subsequent periods of the post-intervention phase revealed no significant decay of the effect. An assessment of the collected data on alcohol-based hand-rub consumption indirectly confirms the main result in all experimental settings. Behavioral outcomes concerning hand hygiene in the hospital are indeed affected by contextual, nudging factors to a significant extent. If properly devised, nudging measures can provide a sustainable contribution to increase hand hygiene compliance in a hospital setting.

In this chapter, I discuss the neuroscientific evidence concerning the role of the visual cortex for inferential semantic processing of concrete vs. abstract words. Results of my review suggest that visual cortex activity not only systematically accompanies inferential processing of concrete words, but it is also an active (facilitating) component of it. This is consistent with the Simulation or Embodied accounts of lexical semantic competence, according to which language understanding in general just consists in imagery/simulation processes underpinned by dedicated areas of the brain (e.g., the visual cortex). However, I show that this is not the case for words referring to abstract concepts: inferential processing of abstract words does not seem to involve visual cortex. The theoretical consequences of this phenomenon are also discussed.

Between the 1970s and 1980s, the empirical basis of cognitive semantics was mainly quantitative data about neurotypical linguistic behavior, such as reaction times, the accuracy of verbal responses, and types of linguistic errors. During the following years, with the emergence of neuroimaging techniques, the situation in this field changed dramatically, marking the transition from cognitive semantics to neurosemantics. In this chapter, I will analyze the neuroscience turn in the empirical study of word meaning. My main claim is that the advent of neuroimaging techniques has revolutionized research in this field, providing essential information that had not been obtained with previous experimental procedures. In particular, neuroimaging supports the hypothesis that semantic representations are partially distributed in sensorimotor neural circuits and inspires “embodied” AI systems integrating linguistic and perceptual data.

For many psychologists, there are tactile pictures—that is, pictures recognized as such via a tactile perceptual mode, notably by the congenitally blind. While the recognitional theory of depiction fully accounts for these data, the subjective resemblance theories have questioned them. For these theories there can be no tactile pictures because, unlike sight, touch has no perceptual point of origin. However, such theories are questionable in this respect. Neuroscience findings show that the congenitally blind can gain perspectival access via touch to the shape of objects and the relations between their depth placements in three-dimensional scenes. More radically, it is hypothesized in this chapter that the congenitally blind, by means of touch, are even able to perceive those three-dimensional groupings in a two-dimensional picture that determine the figurative value of the picture. One can explain these abilities by claiming that not only the perception of shape and depth, but also that of three-dimensional groupings, is supramodal.

A core assumption in the current neurosemantic research is that meanings of concrete words (object nouns, action verbs) are at least partially grounded in modality-specific representations implemented by perceptual and motor cortices. Nevertheless, increasing evidence from the multisensory research suggests that extensive portions of what are traditionally considered modality-specific cortices are in fact supramodal in nature – that is, they can process specific information in multiple sensory modalities and in both normal and sensory-deprived individuals. My central argument in this paper is that the amount of data collected within the supramodal paradigm, although certainly not conclusive, is already robust enough to foster reflections about the role of modality-specificity in the semantic brain and to prompt considerations about the possibility of promoting a property-specific and modality-invariant turn in neurosemantics.

According to the semantic view of computation, computations cannot be individuated without invoking semantic properties. A traditional argument for the semantic view is what we shall refer to as the argument from the cognitive science practice. In its general form, this argument rests on the idea that, since cognitive scientists describe computations (in explanations and theories) in semantic terms, computations are individuated semantically. Although commonly invoked in the computational literature, the argument from the cognitive science practice has never been discussed in detail. In this paper, we shall provide a critical reconstruction of this argument and an extensive analysis of its prospects, taking into account some ways of defending it that have never been explored so far. We shall argue that explanatory considerations support at best a weak version of the argument from the cognitive science practice, according to which semantic properties concur with formal syntactic properties in individuating computations in cognitive science, but not a strong version, according to which computation individuation in cognitive science is semantic as opposed to formal syntactic.

In The Performance of Reading (2006), Peter Kivy argues that reading literary texts is performative in nature, like musical performance, where both require active interpretive engagement. This analogy highlights that both activities involve interpretive decisions and can be silently performed, involving an auditory imagery experience of the inner voice. Nevertheless, Kivy argues that, unlike music, reading is not an intrinsic repeatable activity, mainly because the primary motivation for reading novels is to uncover the plot, and once known, the aesthetic pleasure decreases. In the present paper, we challenge Kivy’s view with both theo- retical and empirical evidence. First, literature, like music, involves cul- tural traditions of repetition and contains multiple layers of interpreta- tion, similar to how repeated musical performances reveal new insights. Second, existing empirical data show that rereading literary texts, in- cluding novels, improves appreciation and comprehension, much like repeated listening to music enhances liking and understanding. Overall, we believe that these considerations suggest that both reading and music allow for repeatable experiences that deepen with each engagement.

Despite recent attention to multimodal imagery, the field remains dominated by the traditional view that mental imagery is divided by sensory modality. However, growing evidence from neuroscience challenges this view, showing that brain areas traditionally thought to be modality-specific actually process sensory information (e.g. shape, motion, or speech) independently from modality, even in sensory-deprived individuals. This paper argues that the assumption of modality-specificity in mental imagery should be significantly revised, if not abandoned. Instead, it proposes a shift in perspective: mental imagery may be better understood in terms of modality-invariant properties, such as shape or frequency, rather than sensory-based divisions.

In the present chapter, I shall argue that neuropsychological data provide some evidence that inferential and referential competences are functionally isolable, i.e., that they can operate independently of one another. In extreme cases, one competence can be completely damaged without this resulting in an impairment of the other, and vice versa (double dissociation). One side of the dissociation, i.e., selective damage to referential abilities, is well attested in the relevant neuropsychological literature. It is common, for instance, in visual agnosia, an impairment of the capacity to recognise visually presented objects which is crucially unrelated to deficit in elementary vision, language, memory, and general cognitive decline. Critically, the patients’ performances in inferential tasks (e.g., definition naming, word-word matching) are usually perfectly preserved. The second side of the dissociation, i.e., the selective impairment of inferential competence, is rarer but also attested. Deficits in inferential performances can be found in a variety of syndromes, such as semantic dementia, semantic aphasia, and Alzheimer’s Disease. None of the syndromes presented above is selective for inferential competence. Nevertheless, as we shall see, selective damage to inferential competence has been observed several times, and the number of cases has grown considerably in recent years.

To vindicate empirically the distinction between inferential competence and referential competence we must show it to be consistent with anatomical data on brain structure in both normal and pathological populations. In this chapter, I shall do this by discussing some direct electrocorticography stimulation studies investigating the neural basis of inferential (i.e., definition) and referential (i.e., visual) naming in pre-surgical epilepsy patients. As I shall argue, however, very few neuroimaging studies are immediately pertinent to this issue. Indirect insights on the neural basis of the two competences come from some studies investigating the distinction between verbal vs non-verbal stimuli in visual and auditory modalities. Direct insights come from a few functional Magnetic Resonance Imaging [fMRI] studies analysing neural activation during visual naming vs definition naming. Of special importance in this context, as we will see, is an fMRI experiment performed by Marconi and colleagues. The authors contrasted two referential tasks involving pictures as stimuli (i.e., visual naming and word-picture matching) with two inferential tasks involving words as stimuli (i.e., definition naming and word-word matching). Taken together, the results of the studies to be discussed in this chapter suggest that, in the normal population, inferential and referential abilities are mediated by partially dissociated cortical networks Some limitations of these studies must, however, be acknowledged.

So far, I have been concerned with the distinction between inferential and referential competence understood as a conceptual distinction, but this distinction can naturally suggest an intriguing empirical hypothesis: inferential and referential semantic abilities are actually underpinned by distinct cognitive systems. In order to assess empirically such dual theory of semantic competence we must map it onto the linguistic tasks that are routinely used in neuropsychology of language. The primary purpose of this chapter is to introduce a distinction between inferential and referential semantic tasks. A secondary aim of the chapter is to begin to discuss the structure of the inferential and referential semantic systems in the human brain. We will see that certain intuitive considerations together with some neuroscientific data suggest that the inferential and the referential semantic systems are not ‘monolithic’ entities: they consist in various, functionally interrelated sub-systems. A final aim of the chapter is to discuss some issues arising in the field of computational modelling of inferential and referential competence.

In the previous chapters, I have analysed some empirical evidence in favour of the proposed distinction between inferential and referential competence and I have outlined a neurocognitive model supporting this distinction at the level of the human brain. In this conclusive chapter, I shall discuss an important potential complication for this general picture, namely the alleged involvement of referential (visual) cortex during inferential tasks, especially when concrete, highly imageable stimuli (words, sentences) are involved in the tasks. According to a popular view, such involvement might reflect (visual) imagery/simulation processes that are essential to language. This would have critical implications for the theory assessed in this book: the cognitive autonomy of inferential competence and referential competence would have to be significantly weakened. In the present chapter, contrary to this popular view, I shall argue that the involvement of referential visual (and perceptual) cortex in inferential tasks should not be overstated.

In this chapter, I shall argue that meaning postulates cannot account for a significant aspect of human lexical competence, namely the ability to apply words to objects and circumstances in the world (referential competence). I shall also argue that the desired account cannot be provided within the theoretical framework of truth-conditional semantics. This problem is highlighted by Kripke’s and Putnam’s arguments against the idea that reference and truth-conditions are cognitively determined. If these arguments are successful, then truth-conditional semantics requires an objective or metaphysical notion of reference, a notion which cannot easily be implemented by a psychological theory of human semantic competence. As we will see, in philosophical semantics, there are two main possible reactions to this difficulty: the first reaction is to force the notion of objective reference within the limits of a psychological theory of competence; the second reaction is to argue that providing a theory of objective reference and providing a theory of referential competence are two radically different endeavours. I shall opt for the second solution, and, for the remainder of this work, I shall be exclusively concerned with referential (vs inferential) competence, as distinct from objective or ‘metaphysical’ reference.

When dealing with ʻmeaningʼ and related notions, one cannot ignore what for a long time was the dominant paradigm in semantics, namely what I shall refer to as truth-conditional cognitivism. According to this paradigm, truth-conditional formal semantics for natural language, in Montagovian or Davidsonian form, is a theory of semantic competence. In this chapter, I shall argue that truth-conditional formal semantics can account for the structural or compositional aspect of human semantic competence, i.e., the ability to understand complex linguistic expressions on the basis of the knowledge of the meanings of the component words and the way in which these words are combined. Furthermore, I shall argue that adding a set of meaning postulates to a standard Montagovian semantic system makes it possible to also model a significant portion of human lexical competence. This is the aspect that is responsible for performances such as material inference, judgments based on semantic relations, word definition, and so on (inferential competence). In the following chapter, however, I shall argue that meaning postulates are insufficient when it comes to explicating the full content of lexical competence.

The primary aim of the article is to take a fresh look at the debate between amodal and grounded (modality-specific) theories of conceptual representations by formulating what I call the challenge from (global) supramodality. The challenge proceeds from the observation that, in recent years, many neuroscience data suggest that extensive portions of what are traditionally considered modality-specific cortices are in fact supramodal in nature; that is, they can process external information independently from the perceptual modality. According to a strong or global interpretation of these data, the entire brain has a task-specific and sensory-independent organization. Within this extreme view, the traditional distinction between modality-specific and amodal representations loses much of its sense. The article aims to explore the implications of (global) supramodality for the debate on the conceptual format. I shall argue that none of the (few) attempts to deal with this issue is ultimately successful, so the challenge remains unsolved.

In this paper, we want to tackle the Molyneux question thoroughly, by addressing it in terms of both ordinary perception and pictorial perception: if a congenitally blind person recovered sight, could she recognize visually the 3D shapes she already recognized tactilely, both when such shapes are given to her directly and when they are given to her pictorially, i.e., as depicted shapes? We want to claim that empirical evidence suggests that the question can be positively answered in both cases. For in the first case, such evidence shows that perception of 3D shapes is supramodal; namely, it can be equivalently achieved in different sense modalities, notably touch and vision, independently of the sensory input such shapes are accessed. While in the second case, such evidence shows that one can satisfy both in vision and in touch the condition for depicted shapes, which are typically not where the perceiver is, to be grasped by that perceiver in a picture’s subject, i.e., what the picture presents. This condition states that the picture’s vehicle, i.e., the typically 2D physical basis of a picture, is enriched by adding to its properties the 3D grouping properties that allow for a figure/ground segmentation to be performed in that vehicle’s elements.

In The Performance of Reading, Peter Kivy introduces, on a purely phenomenological basis, an interesting and potentially fruitful analogy between the experience of silently reading literary texts and the experience of silently reading musical scores. In Kivy’s view, both mental experiences involve a critical element of auditory mental imagery, consisting in having a performance “in the head” or the mind’s ear. This analogy might have significant implications for the ontological status of literary works, as well as for the theoretical relations between music and language. Nevertheless, Kivy’s hypothesis has never been investigated and discussed in its empirical merits. In the present paper, we shall claim that neuroscience data support, at least in part, Kivy’s phenomenological observations about the relation between reading musical scores and reading texts. Despite being functionally and anatomically dissociated at the cognitive level, the two reading experiences both involve an auditory simulation of the content, which seems to be functionally critical for a deep and rich experience of literary texts and musical scores.

This volume brings together new papers advancing contemporary debates in foundational, conceptual, and methodological issues in cognitive neuroscience. The different perspectives presented in each chapter have previously been discussed between the authors, as the volume builds on the experience of Neural Mechanisms Online – webinar series on the philosophy of neuroscience organized by the editors of this volume. The contributed chapters pertain to five core areas in current philosophy of neuroscience. It surveys the novel forms of explanation developed in cognitive neuroscience, and looks at new concepts, methods and techniques used in the field. The book also highlights the metaphysical challenges raised by recent neuroscience and demonstrates the relation between neuroscience and mechanistic philosophy. Finally, the book dives into the issue of neural computations and representations. Assembling contributions from leading philosophers of neuroscience, this work draws upon the expertise of both established scholars and promising early career researchers.

Bayesian approaches to human cognition have been extensively advocated in the last decades, but sharp objections have been raised too within cognitive science. In this paper, we outline a diagnosis of what has gone wrong with the prevalent strand of Bayesian cognitive science (here labelled pure Bayesian cognitive science), relying on selected illustrations from the psychology of reasoning and tools from the philosophy of science. Bayesians’ reliance on so-called method of rational analysis is a key point of our discussion. We tentatively conclude on a constructive note, though: an appropriately modified variant of Bayesian cognitive science can still be coherently pursued, as some scholars have noted.

There are some complex experiences, such as the experiences that allow us to understand linguistic expressions and pictures respectively, which seem to be very similar. For they are stratified experiences in which, on top of grasping certain low-level properties, one also grasps some high-level semantic-like properties. Yet first of all, those similarities notwithstanding, a phenomenologically-based reflection shows that such experiences are different. For a meaning experience has a high-level fold, in which one grasps the relevant expression’s meaning, which is not perceptual, but is only based on a low-level perceptual fold that merely grasps that expression in its acoustically relevant properties. While a pictorial experience, a seeing-in experience, has two folds, the configurational and the recognitional fold, in which one respectively grasps the physical basis of a picture, its vehicle, and what the picture presents, its subject, that are both perceptual, insofar as they are intimately connected. For unlike a meaning experience, in a seeing-in experience one can perceptually read off the picture’s subject from the picture’s vehicle. Moreover, this phenomenological difference is neurologically implemented. For not only the cerebral areas that respectively implement such experiences are different, at least as far as the access to those experiences’ respective high-level content is concerned. As is shown by the fact that one can selectively be impaired in the area respectively implementing the meaning vs. the seeing-in experience without losing one’s pictorial vs. semantic competence respectively. But also, unlike meaning experiences, the area implementing the seeing-in experiential folds is perceptual as a whole. For not only a picture’s subject can be accessed earlier than an expression’s meaning, but also the neural underpinnings of such folds are located in the perceptual areas of the brain.

Semantic perceptualism is the thesis that meaning experiences are forms of perceptual experiences. According to its defenders, this view is motivated not only by philosophical considerations, but also by empirical evidence. In the present article, I shall provide the first comprehensive and critical review of the empirical evidence in support of semantic perceptualism, including a detailed analysis of the relevant neuroanatomical data. The conclusions of my analysis are largely pessimistic. I believe that the relevant behavioral, cognitive, and patient data are suggestive but hardly conclusive. Moreover, neuroanatomical data speak strongly against semantic perceptualism.