Introduction Deep brain stimulation (DBS) is approved under a humanitarian device exemption to manage treatment-resistant obsessive-compulsive disorder (TR-OCD) in adults. It is possible that DBS may be trialed or used clinically off-label in children and adolescents with TR-OCD in the future. DBS is already used to manage treatment-resistant childhood dystonia. Evidence suggests it is a safe and effective intervention for certain types of dystonia. Important questions remain unanswered about the use of DBS in children and adolescents with TR-OCD, including whether (...) mental health clinicians would refer pediatric patients for DBS, and who would be a good candidate for DBS.Objectives To explore mental health clinicians’ views on what clinical and psychosocial factors they would consider when determining which children with OCD would be good DBS candidates.Materials and Methods In depth, semi-structured interviews were conducted with n = 25 mental health clinicians who treat pediatric patients with OCD. The interviews were transcribed, coded, and analyzed using thematic content analysis. Three questions focused on key, clinical, and psychosocial factors for assessing candidacy were analyzed to explore respondent views on candidacy factors. Our analysis details nine overarching themes expressed by clinicians, namely the patient’s previous OCD treatment, OCD severity, motivation to commit to treatment, presence of comorbid conditions, family environment, education on DBS, quality of life, accessibility to treatment, and patient age and maturity.Conclusions Clinicians generally saw considering DBS treatment in youth as a last resort and only for very specific cases. DBS referral was predominantly viewed as acceptable for children with severe TR-OCD who have undertaken intensive, appropriate treatment without success, whose OCD has significantly reduced their quality of life, and who exhibit strong motivation to continue treatment given the right environment. Appropriate safeguards, eligibility criteria, and procedures should be discussed and identified before DBS for childhood TR-OCD becomes practice. (shrink)

Young, middle-aged, and older raters (N=154) evaluated 1,026 prototypical facial poses of neutrality, happiness, anger, disgust, fear, and sadness stemming from 171 young, middle-aged, and older posers. The majority of poses were rated as multi-faceted, that is, to comprise several expressions of varying intensities. Consistent with the notion of age-related increases in negativity–avoidance/positivity effects, crossed-random effects analyses showed an age-related decrease in the attributions of negative, but not positive and neutral, target expressions (that the poser intended to show), and an (...) age-related increase in the attributions of positive and neutral, but not negative, non-target expressions (that the posers did not intend to show). Expressions were more difficult to read the older the posers, particularly for male posers. These age-of-poser effects were independent of the valence of the expression, but partly differed across age groups of raters. The study supports the idea of multi-dimensionality and age-dependency of emotion perception. (shrink)

Intervention studies with developmental samples are difficult to implement, in particular when targeting demographically diverse communities. Online studies have the potential to examine the efficacy of highly scalable interventions aimed at enhancing development, and to address some of the barriers faced by underrepresented communities for participating in developmental research. During the COVID-19 pandemic, we executed a fully remote randomized controlled trial language intervention with third and fourth grade students from diverse backgrounds across the United States. Using this as a case (...) study, we discuss both challenges and solutions to conducting an intensive online intervention through the various phases of the study, including recruitment, data collection, and fidelity of intervention implementation. We provide comprehensive suggestions and takeaways, and conclude by summarizing some important tradeoffs for researchers interested in carrying out such studies. (shrink)

Studies investigating the COVID-19 pandemic from a psychological point of view have mostly focused on psychological distress. This study adopts the framework of existential positive psychology, a second wave of positive psychology that emphasizes the importance of effective coping with the negative aspects of living in order to achieve greater wellbeing. Trait emotional intelligence (trait EI) can be crucial in this context as it refers to emotion-related personality dispositions concerning the understanding and regulation of one’s emotions and those of others. (...) The present study investigated the relationship between trait EI and both wellbeing and psychological distress (i.e., depression, anxiety, and stress), while exploring the mediating role of meaning-centered coping (proactive transformative strategies based on meaning in life) and maladaptive coping (i.e., behavioral disengagement and self-blame) during the first few months of the COVID-19 pandemic. A sample of 326 Lebanese adults completed measures of trait EI, wellbeing, psychological distress, coping, and meaning-centered coping. Results showed a strong positive correlation between trait EI and meaning-centered coping. Trait EI also correlated positively with wellbeing and negatively with psychological distress. Structural equation modeling showed that meaning-centered coping partially mediated the relationship between trait EI and wellbeing. Maladaptive coping fully mediated the relationship between trait EI and psychological distress. Findings indicate that trait EI is positively related to dealing with a stressful situation such as the pandemic in positive ways at both the cognitive level, by reformulating the situation to see something valuable in it, and behavioral level, by being proactive about it. Trait EI was positively linked to seeing the situation as an opportunity for personal growth, finding personal meaning in this situation, maintaining an attitude of hope and courage, and acting more responsibly with one’s self and others during the current crisis. In turn, this coping formula was related to lower psychological distress and improved mental health. These results are consistent with the existential positive psychology framework and can inform implementation programs and policies aiming at raising awareness and promoting healthy and successful coping during the pandemic. (shrink)

Do we need a right to mental privacy? In an era of increasing sophistication in recording, interpreting, and directly intervening on our neural activity – not to mention efforts at combining neural...

“Everyday ethics” is a term that has been used in the clinical and ethics literature for decades to designate normatively important and pervasive issues in healthcare. In spite of its importance, the term has not been reviewed and analyzed carefully. We undertook a literature review to understand how the term has been employed and defined, finding that it is often contrasted to “dramatic ethics.” We identified the core attributes most commonly associated with everyday ethics. We then propose an integrative model (...) of everyday ethics that builds on the contribution of different ethical theories. This model proposes that the function of everyday ethics is to serve as an integrative concept that (1) helps to detect current blind spots in bioethics (that is, shifts the focus from dramatic ethics) and (2) mobilizes moral agents to address these shortcomings of ethical insight. This novel integrative model has theoretical, methodological, practical, and pedagogical implications, which we explore. Because of the pivotal role that moral experience plays in this integrative model, the model could help to bridge empirical ethics research with more conceptual and normative work. (shrink)

Following the neurophenomenological approach, we propose a model of emotional emergence that identifies the experimental structures of time involved in emotional experience and their plausible components in terms of cognition, physiology, and neuroscience. We argue that surprise, as a lived experience, and its physiological correlates of the startle reflex and cardiac defense are the core of the dynamic, and that the heart system sets temporally in motion the dynamic of emotional emergence. Finally, in reference to Craig’s model of emotion, we (...) propose an integrative model of the temporal dynamic of emotional emergence that allows emotions to be distinguished depending on each temporal phase and that involves the following three systems: the brain , the consciousness , and the doubled-sided continuum of the body-heart context, with the heart as the focus within the body during emotion. This model provides the framework for future developments in 1st- and 3rd-person approaches for an integrative understanding of the science of emotion, including the fields of psychophysiology and psychopathology. (shrink)

A collaborative article by the Editorial Collective of Social Imaginaries. Investigations into social imaginaries have burgeoned in recent years. From ‘the capitalist imaginary’ to the ‘democratic imaginary’, from the ‘ecological imaginary’ to ‘the global imaginary’ – and beyond – the social imaginaries field has expanded across disciplines and beyond the academy. The recent debates on social imaginaries and potential new imaginaries reveal a recognisable field and paradigm-in-the-making. We argue that Castoriadis, Ricoeur, and Taylor have articulated the most important theoretical frameworks (...) for understanding social imaginaries, although the field as a whole remains heterogeneous. We further argue that the notion of social imaginaries draws on the modern understanding of the imagination as authentically creative. We contend that an elaboration of social imaginaries involves a significant, qualitative shift in the understanding of societies as collectively and politically-instituted formations that are irreducible to inter-subjectivity or systemic logics. After marking out the contours of the field and recounting a philosophical history of the imagination, the essay turns to debates on social imaginaries in more concrete contexts, specifically political-economic imaginaries, the ecological imaginary, multiple modernities and their inter-civilisational encounters. The social imaginaries field imparts powerful messages for the human sciences and wider publics. In particular, social imaginaries hold significant implications for ontological, phenomenological and philosophical anthropological questions; for the cultural, social, and political horizons of contemporary worlds; and for ecological and economic phenomena. The essay concludes with the argument that social imaginaries as a paradigm-in-the-making offers valuable means by which movements towards social change can be elucidated as well providing an open horizon for the critiques of existing social practices. (shrink)

Many believe that the ethical problems of donation after cardiocirculatory death (DCD) have been "worked out" and that it is unclear why DCD should be resisted. In this paper we will argue that DCD donors may not yet be dead, and therefore that organ donation during DCD may violate the dead donor rule. We first present a description of the process of DCD and the standard ethical rationale for the practice. We then present our concerns with DCD, including the following: (...) irreversibility of absent circulation has not occurred and the many attempts to claim it has have all failed; conflicts of interest at all steps in the DCD process, including the decision to withdraw life support before DCD, are simply unavoidable; potentially harmful premortem interventions to preserve organ utility are not justifiable, even with the help of the principle of double effect; claims that DCD conforms with the intent of the law and current accepted medical standards are misleading and inaccurate; and consensus statements by respected medical groups do not change these arguments due to their low quality including being plagued by conflict of interest. Moreover, some arguments in favor of DCD, while likely true, are "straw-man arguments," such as the great benefit of organ donation. The truth is that honesty and trustworthiness require that we face these problems instead of avoiding them. We believe that DCD is not ethically allowable because it abandons the dead donor rule, has unavoidable conflicts of interests, and implements premortem interventions which can hasten death. These important points have not been, but need to be fully disclosed to the public and incorporated into fully informed consent. These are tall orders, and require open public debate. Until this debate occurs, we call for a moratorium on the practice of DCD. (shrink)

BackgroundPhysical activity is known to improve mental health, and is regarded as safe and desirable for uncomplicated pregnancy. In this novel study, we aim to evaluate whether there are associations between maternal physical activity during pregnancy and neonatal brain cortical development.MethodsForty-four mother/newborn dyads were included in this longitudinal study. Healthy pregnant women were recruited and their physical activity throughout pregnancy were documented using accelerometers worn for 3–7 days for each of the 6 time points at 4–10, ∼12, ∼18, ∼24, ∼30, (...) and ∼36 weeks of pregnancy. Average daily total steps and daily total activity count as well as daily minutes spent in sedentary/light/moderate/vigorous activity modes were extracted from the accelerometers for each time point. At ∼2 weeks of postnatal age, their newborns underwent an MRI examination of the brain without sedation, and 3D T1-weighted brain structural images were post-processed by the iBEAT2.0 software utilizing advanced deep learning approaches. Cortical surface maps were reconstructed from the segmented brain images and parcellated to 34 regions in each brain hemisphere, and mean cortical thickness for each region was computed for partial correlation analyses with physical activity measures, with appropriate multiple comparison corrections and potential confounders controlled.ResultsAt 4–10 weeks of pregnancy, mother’s daily total activity count positively correlated (FDR corrected P ≤ 0.05) with newborn’s cortical thickness in the left caudal middle frontal gyrus (rho = 0.48, P = 0.04), right medial orbital frontal gyrus (rho = 0.48, P = 0.04), and right transverse temporal gyrus (rho = 0.48, P = 0.04); mother’s daily time in moderate activity mode positively correlated with newborn’s cortical thickness in the right transverse temporal gyrus (rho = 0.53, P = 0.03). At ∼24 weeks of pregnancy, mother’s daily total activity count positively correlated (FDR corrected P ≤ 0.05) with newborn’s cortical thickness in the left (rho = 0.56, P = 0.02) and right isthmus cingulate gyrus (rho = 0.50, P = 0.05).ConclusionWe identified significant relationships between physical activity in healthy pregnant women during the 1st and 2nd trimester and brain cortical development in newborns. Higher maternal physical activity level is associated with greater neonatal brain cortical thickness, presumably indicating better cortical development. (shrink)

ObjectiveTo assess distracted attention and performance on a computer task following completion of a sustained attention and acute media multitasking task among adolescents with varying self-reported usual media multitasking.MethodsNinety-six 13- to 17-year-olds played the video game Tetris following completion of a Go/No-go paradigm to measure sustained attention in the presence of distractors, an acute media multitasking, or a passive viewing condition. Adolescents completed the conditions on separate visits in randomized order. Sustained attention was measured within the Go/No-go task by measuring (...) errors of omission. Distracted attention while playing the Tetris task was measured by computing eye tracking measures of attention to irrelevant distractor images that bordered the Tetris game. Participants also self-reported their daily media multitasking.ResultsThe Go/No-go task revealed important qualitative differences in sustained attention among low and high usual media multitaskers. There was a uniform improvement in sustained attention among low usual media multitaskers, demonstrated by a consistent linear decrease in omission errors. Among high usual media multitaskers, there was initially a decrease in sustained attention followed by an increase. Completing the Go/No-go task also statistically significantly reduced distractibility and increased performance while playing Tetris compared to the passive viewing condition, but only among those with low usual media multitasking. There was a non-statistically significant trend that completing the acute media multitask increased subsequent distractibility and performance while playing Tetris among high media multitaskers.ConclusionIn this sample of adolescents, practicing a sustained attention task reduces distractibility and improves task performance among those who have low levels of usual media multitasking. (shrink)

Curiosity is widely acknowledged as a crucial aspect of children’s development and as an important part of the learning process, with prior research showing associations between curiosity and achievement. Despite this evidence, there is little research on the development of curiosity or on promoting curiosity in school settings, and measures of curiosity promotion in the classroom are absent from the published literature. This article introduces the Curiosity in Classrooms Framework coding protocol, a tool for observing and coding instructional practices that (...) support the promotion of curiosity. We describe the development of the framework and observation instrument and the results of a feasibility study using the protocol, which gives a descriptive overview of curiosity-promoting instruction in 35 elementary-level math lessons. Our discussion includes lessons learned from this work and suggestions for future research using the developed observation tool. (shrink)

School psychologists are asked to systematically evaluate the effects of their work to ensure quality standards. Given the different types of methods applied to different users of school psychology measuring the effects of school psychological services is a complex task. Thus, the focus of our scoping review was to systematically investigate the state of past research on the measurement of the effects of school psychological services published between 1998 and 2018 in eight major school psychological journals. Of the 5,048 peer-reviewed (...) articles published within this period, 623 were coded by two independent raters as explicitly refering to school psychology or counseling in the school context in their titles or abstracts. However, only 22 included definitions of effects of school psychological services or described outcomes used to evaluate school psychological services based on full text screening. These findings revealed that measurement of the effects of school psychological services has not been a focus of research despite its' relevance in guidelines of school psychological practice. (shrink)

Context: Participatory arts-based methods such as photovoice, drama and music have increasingly been used to engage young people who are exposed to psychosocial risks. These methods have the potential to empower youth and provide them with an accessible and welcoming environment to express and manage difficult feelings and experiences. These effects are, however, dependent on the way these methods are implemented and how potential ethical concerns are handled. Objective: Using the current literature on arts-based health research as a foundation, this (...) paper examines ethical issues emerging from participatory arts methods with young people with traumatic experiences. Results: We present a typology covering relevant issues such as power, accessibility, communication, trust and ownership, across the domains of partnership working, project entry, participation and dissemination. Drawing on our extensive clinical and research experiences, existing research and novel in-practice examples, we offer guidance for ethical dilemmas that might arise at different phases of research. Conclusion: Adequate anticipation and consideration of ethical issues, together with the involvement of young people, will help ensure that arts methods are implemented in research and practice with young people in a fair, meaningful and empowering way. Patient or Public Contribution: The issues reviewed are largely based on the authors' experience conducting participatory research. Each of the projects referenced has its own systems for PPI including, variously, consultations with advisory groups, coproduction, youth ambassadors and mentor schemes. One of the coauthors, Josita Kavitha Thirumalai, is a young person trained in peer support and has provided extensive input across all stages. (shrink)

When using sample data to decide whether two populations differ, laypeople attend to the difference between group means, but largely overlook within-group variability (Obrecht, Chapman, & Gelman, 2007). We show, first, that laypeople know about and use story-implied variability when making pairwise comparisons. Then we demonstrate that participants' sensitivity to variance in a dataset is boosted when presented in a context that implies consistent variance information. Statistical data were couched in stories about electrical conductivity measurements obtained from element samples (low-variability (...) category) or body weight measurements from samples of peoples (high-variability category). We manipulated, between participants, whether the data variance matched or mismatched the story-implied variability. Participants who received data in a matching context showed high sensitivity to variance, while those in the mismatching condition did not. Laypeople use statistical data to make reasonable inferences when those data are provided in a context that makes sense. (shrink)

The sense of agency has received much attention in the context of individual action but not in the context of joint action. We investigated how the sense of agency developed during individual and dyadic performance while people learned a haptic coordination task. The sense of agency increased with better performance in all groups. Individuals and dyads showed a differential sense of agency after initial task learning, with dyads showing a minimal increase. The sense of agency depended on the context in (...) which the task was first learnt, as transfer from joint to individual performance resulted in an illusory boost in the sense of agency. Whereas the quality of performance related to the sense of agency, the generated forces to achieve the task did not. Our findings are consistent with a predictive model account at the perceptual level, such that the sense of agency relies most strongly on sharable perceptual information. (shrink)

Teaching responsible conduct of research (RCR) to PhD students is crucial for fostering responsible research practice. In this paper, we show how the use of Moral Case Deliberation—a case reflection method used in the Amsterdam UMC RCR PhD course—is particularity valuable to address three goals of RCR education: (1) making students aware of, and internalize, RCR principles and values, (2) supporting reflection on good conduct in personal daily practice, and (3) developing students’ dialogical attitude and skills so that they can (...) deliberate on RCR issues when they arise. What makes this method relevant for RCR education is the focus on values and personal motivations, the structured reflection on real experiences and dilemmas and the cultivation of participants’ dialogical skills. During these structured conversations, students reflect on the personal motives that drive them to adhere to the principles of good science, thereby building connections between those principles and their personal values and motives. Moreover, by exploring personal questions and dilemmas related to RCR, they learn how to address these with colleagues and supervisors. The reflection on personal experiences with RCR issues and questions combined with the study of relevant normative frameworks, support students to act responsibly and to pursue RCR in their day-to-day research practice in spite of difficulties and external constraints. (shrink)

Clinical mental health researchers may understandably struggle with how to incorporate biological assessments in clinical research. The options are numerous and are described in a vast and complex body of literature. Here we provide guidelines to assist mental health researchers seeking to include biological measures in their studies. Apart from a focus on behavioral outcomes as measured via interviews or questionnaires, we advocate for a focus on biological pathways in clinical trials and epidemiological studies that may help clarify pathophysiology and (...) mechanisms of action, delineate biological subgroups of participants, mediate treatment effects, and inform personalized treatment strategies. With this paper we aim to bridge the gap between clinical and biological mental health research by (1) discussing the clinical relevance, measurement reliability, and feasibility of relevant peripheral biomarkers; (2) addressing five types of biological tissues, namely blood, saliva, urine, stool and hair; and (3) providing information on how to control sources of measurement variability. (shrink)

There has long been interest in identifying and studying ‘‘successful psychopaths.” This study sampled psychologists with an interest in law, attorneys, and clinical psychology professors to obtain descriptions of individuals considered to be psychopaths who were also successful in their endeavors. The results showed a consistent description across professions and convergence with descriptions of traditional psychopathy, though the successful psychopathy profile had higher scores on conscientiousness, as measured within the five-factor model (FFM). These results are useful in documenting the existence (...) of successful psychopathy, demonstrating the potential benefit of informant methodology, and providing an FFM description that distinguishes successful psychopaths from unsuccessful psychopaths studied more routinely within prison settings. (shrink)

Mirror-touch synaesthesia is a condition where observing touch to another’s body induces a subjective tactile sensation on the synaesthetes body. The present study explores which characteristics of the inducing stimulus modulate the synaesthetic touch experience. Fourteen mirror-touch synaesthetes watched videos depicting a touch event while indicating whether the video induced a tactile sensation, on which side of their body they felt this sensation and the intensity of the experienced sensation. Results indicate that the synaesthetes experience stronger tactile sensations when observing (...) touch to real bodies, whereas observing touch to dummy bodies, pictures of bodies and disconnected dummy body parts elicited weaker sensations. These results suggest that mirror-touch synaesthesia is not entirely bottom-up driven, but top-down information, such as knowledge about real and dummy body parts, also modulate the intensity of the experience. (shrink)

ABSTRACTFacial stimuli are widely used in behavioural and brain science research to investigate emotional facial processing. However, some studies have demonstrated that dynamic expressions elicit stronger emotional responses compared to static images. To address the need for more ecologically valid and powerful facial emotional stimuli, we created Dynamic FACES, a database of morphed videos from younger, middle-aged, and older adults displaying naturalistic emotional facial expressions. To assess adult age differences in emotion identification of dynamic stimuli and to provide normative ratings (...) for this modified set of stimuli, healthy adults categorised for each video the emotional expression displayed, rated the expression distinctiveness, estimated the age of the face model, and rated the naturalness of the expression. We found few age differences in emotion identification when using dynamic stimuli. On... (shrink)

Background Supporting physicians in Intensive Care Units s as they face dying patients at unprecedented levels due to the COVID-19 pandemic is critical. Amidst a dearth of such data and guided by evidence that nurses in ICUs experience personal, professional and existential issues in similar conditions, a systematic scoping review is proposed to evaluate prevailing accounts of physicians facing dying patients in ICUs through the lens of Personhood. Such data would enhance understanding and guide the provision of better support for (...) ICU physicians. Methods An SSR adopts the Systematic Evidenced Based Approach to map prevailing accounts of caring for dying patients in ICUs. To enhance the transparency and reproducibility of this process, concurrent and independent use of tabulated summaries, thematic analysis and directed content analysis is adopted. Results Eight thousand three hundred fifty-eight abstracts were reviewed from four databases, 474 full-text articles were evaluated, 58 articles were included, and the Split Approach revealed six categories/themes centered around the Innate, Individual, Relational and Societal Rings of Personhood, conflicts in providing end of life care and coping mechanisms employed. Conclusion This SSR suggests that caring for dying patients in ICU impacts how physicians view their personhood. To resolve conflicts within individual concepts of personhood, physicians use prioritization, reframing and rely on accessible, personalized support from colleagues to steer coping strategies. An adapted form of the Ring Theory of Personhood is proposed to direct timely personalized, appropriate and holistic support. (shrink)

Background This study assesses how pediatric assent is conceptualized and justified within the therapeutic context. Pediatric ethicists generally agree that children should participate in medical care decisions in developmentally appropriate ways. Much attention has been paid to pediatric assent for research participation, but ambiguities persist in how assent is conceptualized and operationalized in the therapeutic context where countervailing considerations such as the child’s best interest and parental permission must also be weighed.Methods Searches were conducted in 11 databases including PubMed, Embase, (...) Cochrane Library, and Web of Science. Articles published between 2010 and 2020 were screened in COVIDENCE for meeting each of four criteria: (1) focusing on pediatric assent, (2) focusing on clinical care, (3) including normative claims, and (4) containing substantive statements about the meaning of pediatric assent. Full texts were abstracted for (1) operational definitions of assent, (2) discussion of the temporal nature of assent, (3) description of the concept of “understanding,” and (4) ethical justifications for soliciting assent. These excerpts were coded and code patterns formed themes presented in the results.Results The final analytic data set contained 29 articles. Analysis yielded three key themes. First, valid assent varies by treatment, population (e.g., younger versus older), and geographic/cultural context. Second, assent represents two distinct longitudinal processes: One involves eliciting preferences over a disease course or care episode; the other focuses on children’s developmental maturation. Third, ethical justifications for assent draw variously on instrumental and intrinsic reasons, but often remain ambiguous.Conclusions There is widespread agreement that assent is morally valuable, but there remain substantial ambiguities or disagreements about its meaning, process, and ethical justification. (shrink)

ABSTRACT:Bioethicists today are taking a greater role in the design and implementation of emerging technologies by "embedding" within the development teams and providing their direct guidance and recommendations. Ideally, these collaborations allow ethical considerations to be addressed in an active, iterative, and ongoing process through regular exchanges between ethicists and members of the technological development team. This article discusses a challenge to this embedded ethics approach—namely, that bioethical guidance, even if embraced by the development team in theory, is not easily (...) actionable in situ. Many of the ethical problems at issue in emerging technologies are associated with preexisting structural, socioeconomic, and political factors, making compliance with ethical recommendations sometimes less a matter of choice and more a matter of feasibility. Moreover, incentive structures within these systemic factors maintain them against reform efforts. The authors recommend that embedded bioethicists utilize principles from behavioral science (such as behavioral economics) to better understand and account for these incentive structures so as to encourage the ethically responsible uptake of technological innovations. (shrink)

Potential conflicts between the roles of physicians and researchers have been described at the theoretical level in the bioethics literature (Czoli, et al., 2011). Physicians and researchers are generally in mutually distinct roles, responsible for patients and participants respectively. With increasing emphasis on integration of research into clinical settings, however, the role divide is sometimes unclear. Consequently, physician–researchers must consider and negotiate salient ethical differences between clinical– and research–based obligations (Miller et al, 1998). This paper explores the subjective experiences and (...) perspectives of 30 physician–researchers working in three Canadian paediatric settings. Drawing on qualitative interviews, it identifies ethical challenges and strategies used by physician–researchers in managing dual roles. It considers whether competing obligations could have both positive and adverse consequences for both physician–researchers and patients. Finally, we discuss how empirical work, which explores the perspectives of those engaged in research and clinical practice, can lead the way to understanding and promoting best practice. (shrink)

Background: Little is known about U.S. healthcare provider views and practices regarding evidence, counseling, and shared decision-making about in-hospital versus out-of-hospital birth settings. Methods: We conducted 19 in-depth, semistructured, qualitative interviews of eight obstetricians, eight midwives, and three pediatricians from across the United States. Interviews explored healthcare providers’ interpretation of the current evidence and their personal and professional experiences with childbirth within the existing medical, ethical, and legal context in the United States. Results: Themes emerged concerning risks and benefits, decision-making, (...) and patient-provider power dynamics. Collectively, the narratives illuminated fundamental ideological tensions between in- and out-of-hospital providers arising from divergent assignment of value to described risks and benefits. The majority of physicians focused on U.S.-specific data demonstrating increased neonatal morbidity and mortality associated with delayed access to hospital-based interventions, thereby justifying hospital birth as the standard of care. By contrast, midwives emphasized data demonstrating fewer interventions and superior maternal and neonatal outcomes in high-income European countries, where out-of-hospital birth is more common for low-risk birthing people. A key gap in counseling was revealed, as no interviewees offered anticipatory counseling regarding birth setting options. Providers directly and indirectly illustrated the propensity for asymmetric power relations between birth providers and pregnant people, especially in hospital settings. Conclusions: The narratives highlight the common goal of optimizing maternal and neonatal outcomes despite tensions arising from divergent prioritization of specific maternal and neonatal risks. Our findings suggest opportunities to foster collaboration and optimize outcomes via mutual respect and improved integration of care. (shrink)

le statut de l'intersubjectivité comme altérité à soi chez Husserl Natalie Depraz. REMERCIEMENTS À Jean-François Courtine tout d'abord, je tiens à exprimer ma très vive gratitude pour la confiance qu'il m'a témoignée en me donnant ...

This astonishing book features over 150 unprecedented color photographs taken by Christian Ziegler himself as he trekked through wilderness on five continents to capture the diversity and magnificence of orchids in their natural habitats.

In the absence of pre‐established communicative conventions, people create novel communication systems to successfully coordinate their actions toward a joint goal. In this study, we address two types of such novel communication systems: sensorimotor communication, where the kinematics of instrumental actions are systematically modulated, versus symbolic communication. We ask which of the two systems co‐actors preferentially create when aiming to communicate about hidden object properties such as weight. The results of three experiments consistently show that actors who knew the weight (...) of an object transmitted this weight information to their uninformed co‐actors by systematically modulating their instrumental actions, grasping objects of particular weights at particular heights. This preference for sensorimotor communication was reduced in a fourth experiment where co‐actors could communicate with weight‐related symbols. Our findings demonstrate that the use of sensorimotor communication extends beyond the communication of spatial locations to non‐spatial, hidden object properties. (shrink)

Everyday ethics refers to those issues which have a sometimes unrecognized moral dimension and that arise regularly within healthcare and research. These issues are often contrasted to dramatic ethics issues (i.e. issues that have seemingly higher stakes such as those arising in acute care situations or with invasive or life-threatening interventions). Claims have been made that scholarly bioethics tends to focus on dramatic ethics to the detriment of everyday ethics discussions. However, empirical evidence showing this has been lacking. Our own (...) research investigating bioethics discussions in the Parkinson’s disease literature suggested this trend. Consequently, we decided to characterize the context and content of the Parkinson’s disease bioethics literature to empirically test the hypothesis that everyday ethics is under discussed. We conducted a broad literature search using the keywords “Parkinson’s disease” AND (“ethics” OR “bioethics”) and classified results inductively based on the context in which the bioethics discussion occurred. In line with our hypothesis and initial observations, we found that there is indeed a greater focus on dramatic ethics where topics such as deep brain stimulation and neuronal cell transplantations, dominated bioethics discussions. Given the potential utility of everyday ethics in improving healthcare and research, this mismatch in focus ought to be addressed. There is a clear need for further understanding and discussion of everyday ethical issues in scholarly bioethics. (shrink)

What is the nature of the social sciences? What kinds of knowledge can they—and should they—hope to create? Are objective viewpoints possible and can universal laws be discovered? Questions like these have been asked with increasing urgency in recent years, as some philosophers and researchers have perceived a "crisis" in the social sciences. Metatheory in Social Science offers many provocative arguments and analyses of basic conceptual frameworks for the study of human behavior. These are offered primarily by practicing researchers and (...) are related to problems in disciplines as diverse as sociology, psychology, psychiatry, anthropology, and philosophy of science. While various points of view are expressed in these nineteen essays, they have in common several themes, including the comparison of social and natural science, the role of knowledge in meeting the demands of society and its pressing problems, and the nature and role of subjectivity in science. Some authors hold that subjectivity cannot be studied scientifically; others argue that it can and must be if progress in knowledge is to be made. The essays demonstrate the philosophical pluralism they discuss and give a wide range of alternative positions on the future of the social and behavioral sciences in a postpositivist intellectual world. (shrink)

Philosophers, psychologists, neuroscientists, and psychiatrists examine the will and its pathologies from theoretical and empirical perspectives, offering a conceptual overview and discussing schizophrenia, depression, prefrontal lobe damage, and substance abuse as disorders of volition. Science tries to understand human action from two perspectives, the cognitive and the volitional. The volitional approach, in contrast to the more dominant "outside-in" studies of cognition, looks at actions from the inside out, examining how actions are formed and informed by internal conditions. In Disorders of (...) Volition, scholars from a range of disciplines seek to advance our understanding of the processes supporting voluntary action by addressing conditions in which the will is impaired. Philosophers, psychologists, neuroscientists, and psychiatrists examine the will and its pathologies from both theoretical and empirical perspectives, offering a conceptual overview and discussing specific neurological and psychiatric conditions as disorders of volition. After presenting different conceptual frameworks that identify agency, decision making, and goal pursuit as central components of volition, the book examines how impairments in these and other aspects of volition manifest themselves in schizophrenia, depression, prefrontal lobe damage, and substance abuse. Contributors George Ainslie, Tim Bayne, Antoine Bechara, Paul W. Burgess, Anna-Lisa Cohen, Daniel Dennett, Stéphanie Dubal, Philippe Fossati, Chris Frith, Sam J. Gilbert, Peter Gollwitzer, Jordan Grafman, Patrick Haggard, Jay G. Hull, Marc Jeannerod, Roland Jouvent, Frank Krueger, Neil Levy, Peter F. Liddle, Kristen L. Mackiewitz, Thomas Metzinger, Jack B. Nitschke, Jiro Okuda, Adrian M. Owen, Chris Parry, Wolfgang Prinz, Joëlle Proust, Michael A. Sayette, Werner X. Schneider, Natalie Sebanz, Jon S. Simons, Laurie B. Slone, Sean A. Spence. (shrink)

Game theory is central to modern understandings of how people deal with problems of coordination and cooperation. Yet, ironically, it cannot give a straightforward explanation of some of the simplest forms of human coordination and cooperation--most famously, that people can use the apparently arbitrary features of "focal points" to solve coordination problems, and that people sometimes cooperate in "prisoner's dilemmas." Addressing a wide readership of economists, sociologists, psychologists, and philosophers, Michael Bacharach here proposes a revision of game theory that resolves (...) these long-standing problems. In the classical tradition of game theory, Bacharach models human beings as rational actors, but he revises the standard definition of rationality to incorporate two major new ideas. He enlarges the model of a game so that it includes the ways agents describe to themselves their decision problems. And he allows the possibility that people reason as members of groups, each taking herself to have reason to perform her component of the combination of actions that best achieves the group's common goal. Bacharach shows that certain tendencies for individuals to engage in team reasoning are consistent with recent findings in social psychology and evolutionary biology. As the culmination of Bacharach's long-standing program of pathbreaking work on the foundations of game theory, this book has been eagerly awaited. Following Bacharach's premature death, Natalie Gold and Robert Sugden edited the unfinished work and added two substantial chapters that allow the book to be read as a coherent whole. (shrink)

Understanding the link between brain evolution and the evolution of distinctive features of modern human cognition is a fundamental challenge. A still unresolved question concerns the co-evolution of tool behavior (i.e., tool use or tool making) and language. The shared neurocognitive processes hypothesis suggests that the emergence of the combinatorial component of language skills within the frontal lobe/Broca's area made possible the complexification of tool-making skills. The importance of the frontal lobe/Broca's area in tool behavior is somewhat surprising with regard (...) to the literature on neuropsychology and cognitive neuroscience, which has instead stressed the critical role of the left inferior parietal lobe. Therefore, to be complete, any version of the shared neurocognitive processes hypothesis needs to integrate the potential interactions between the frontal lobe/Broca's area and the left inferior parietal lobe as well as their co-evolution at a phylogenetic level. Here, we sought to provide the first elements of answer through the use of the massive deployment framework, which posits that evolutionarily older brain areas are deployed in more cognitive functions (i.e., they are less specific). We focused on the left parietal cortex, and particularly the left areas PF, PGI, and anterior intraparietal (AIP), which are known to be involved in tool use, language, and motor control, respectively. The deployment of each brain area in different cognitive functions was measured by conducting a meta-analysis of neuroimaging studies. Our results confirmed the pattern of specificity for each brain area and also showed that the left area PGI was far less specific than the left areas PF and AIP. From these findings, we discuss the different evolutionary scenarios depicting the potential co-evolution of the combinatorial and generative components of language and tool behavior in our lineage. (shrink)

This paper considers the argument that we have a duty to colonise other planets because we owe it to future generations. It puts forward the view that formulations of this argument in the current literature are confused. It distinguishes (at least) four versions of the argument and shows that none of them are compelling. It draws the conclusion that, should people put forward these arguments, they ought to be more precise in their formulations and more rigorous in their defence.