Obstetric Fistula is an abnormal opening between the vagina and rectum resulting from prolonged and obstructed labour. Studies indicate that delays in accessing maternal care and home birth contribute to the development of fistula. Survivors are usually women of low socioeconomic status residing in rural locations. This study explores the birthing experiences of 15 fistula survivors through a narrative inquiry approach at a repair centre in North‐central Nigeria. Using structural violence as a lens, it describes the role of social, political (...) and health systems in the inequitable access to care for women. For women opting for home births, preference for home delivery was mainly due to lack of finances, poor health systems and cultural practices. Rural location inhibited access as women seeking facility delivery faced transfer delays to referral centres when complications developed. Inequitable maternal health services in rural locations in Nigeria are inherently linked to access to health care, and these contribute to the increased incidence of fistulae. Structural intervention is a health policy priority to address poor health systems and achieve universal health coverage to address maternal health issues in Nigeria. (shrink)

The synergies between viral and bacterial infections are well established. Most studies have been focused on the indirect mechanisms underlying this phenomenon, including immune modulation and alterations to the mucosal structures that promote pathogen outgrowth. A growing body of evidence implicates direct binding of virus to bacterial surfaces being an additional mechanism of synergy at the host–pathogen interface. These cross‐kingdom interactions enhance bacterial and viral adhesion and can alter tissue tropism. These bacterial–viral complexes play unique roles in pathogenesis and can (...) alter virulence potential. The bacterial–viral complexes may also play important roles in pathogen transmission. Additionally, the complexes are recognized by the host immune system in a distinct manner, thus presenting novel routes for vaccine development. These synergies are active for multiple species in both the respiratory and gastrointestinal tract, indicating that direct interactions between bacteria and virus to modulate host interactions are used by a diverse array of species. (shrink)

To what extent do people attribute meanings to “nonsense” words? How general is such attribution of meaning? We used a set of words lacking conventional meanings to elicit drawings of made‐up creatures. Separate groups of participants rated the nonsense words and the drawings on several semantic dimensions and selected what name best corresponded to each creature. Despite lacking conventional meanings, “nonsense” words elicited a high level of consistency in the produced drawings. Meaning attributions made to nonsense words corresponded with meaning (...) attributions made by separate people to drawings that were inspired by the name. Naïve participants were able to recover the name that inspired the drawing with greater‐than‐chance accuracy. These results suggest that people make liberal and consistent use of non‐arbitrary relationships between forms and meanings.Open Research Badges This article has been awarded Open Materials and Open Data badges. All materials and data are publicly accessible via the Open Science Framework at https://osf.io/8juyc/. Learn more about the Open Practices badges from the Center for Open Science: https://osf.io/tvyxz/wiki. (shrink)

In this paper we connect diversity with being on the margins of philosophy. We do this by reflecting on the programme that we, as diverse philosophers, designed and taught in a small university. Recently, the programme was closed. We examine some of the circumstances for the closure, in particular the impact of league tables. We argue that an idea (or ideal?) of objectivity, as a method in both science and philosophy, plays a role in establishing and maintaining the outsider status (...) of the philosopher at the margins of the discipline. As a counterpoint to objectivity, we offer concrete examples of our experiences to illustrate what it is like to be at the margins of philosophy. We end with an examination of topics that are common to academics, i.e. issues of time and resources, that are compounded at the margins. Our paper seeks to show what is lost by the closure of our programme, and what philosophy loses when marginalised philosophers are silenced and/or excluded from key academic discourse. We argue that the particular contribution of the philosopher at the margin offers an important and irreplaceable contribution to discourses on the identity of philosophy and on the value of diversity. (shrink)

Yasemin J. Erden, Hannah M. Altorf ABSTRACT: In this paper we connect diversity with being on the margins of philosophy. We do this by reflecting on the programme that we, as diverse philosophers, designed and taught in a small university. Recently, the programme was closed. We examine some of the circumstances for the closure, in ….

ObjectivesQuality of Life depends on the discrepancy between desired and current experiences, thus in chronic illness, adjustment of expectations and interpretation of the current situation are crucial. Depression is known to influence this gap, and the present study aims to further assess the role of resilience and health locus of control.MethodsA total of 94 patients with neurological disorders were screened via telephone regarding depression, resilience and HLC. Current and desired state of several life domains were assessed, such as Fitness, General (...) Health, Pain, Daily Activities, Finances, Leisure, and Family. Elastic net regularization and analyses of variance were used to disentangle the impact of depression, resilience, HLC, and sociodemographic factors on the perception of current and desired state, and the gap between both.ResultsA gap was present for all domains but largest for pain. Interpretation of the current state was linked to desired state, HLC, and age. All gaps were related to depression; certain domains were in addition influenced by resilience, HLC and sociodemographic factors. Of note, for most domains, patients did not select the highest possible desired state.ConclusionOlder patients with neurological disorders report a gap between current and desired state for many aspects of life. Adjusting expectations is beneficial in the face of declining health, but a reasonably increased desired state may positively influence the perception of the current situation. Depression negatively influences the interpretation of the Calman gap. (shrink)

Neural substrates of fatigue in traumatic brain injury are not well understood despite the considerable burden of fatigue on return to productivity. Fatigue is associated with diminishing performance under conditions of high cognitive demand, sense of effort, or need for motivation, all of which are associated with cognitive control brain network integrity. We hypothesize that the pathophysiology of TBI results in damage to diffuse cognitive control networks, disrupting coordination of moment-to-moment monitoring, prediction, and regulation of behavior. We investigate the cingulo-opercular (...) and frontoparietal networks, which are engaged to sustain attention for task and maintain performance. A total of 61 individuals with mild TBI and 42 orthopedic control subjects participated in functional MRI during performance of a constant effort task requiring altering the amount of effort utilized to manually squeeze a pneumostatic bulb across six 30-s trials. Network-based statistics assessed within-network organization and fluctuation with task manipulations by group. Results demonstrate small group differences in network organization, but considerable group differences in the evolution of task-related modulation of connectivity. The mild TBI group demonstrated elevated CO connectivity throughout the task with little variation in effort level or time on task, while CO connectivity diminished over time in controls. Several interregional CO connections were predictive of fatigue in the TBI group. In contrast, FP connectivity fluctuated with task manipulations and predicted fatigue in the controls, but connectivity fluctuations were delayed in the mild traumatic brain injury group and did not relate to fatigue. Thus, the mTBI group’s hyper-connectivity of the CO irrespective of task demands, along with hypo-connectivity and delayed peak connectivity of the FP, may allow for attainment of task goals, but also contributes to fatigue. Findings are discussed in relation to performance monitoring of prediction error that relies on internal cues from sensorimotor feedback during task performance. Delay or inability to detect and respond to prediction errors in TBI, particularly evident in bilateral insula-temporal CO connectivity, corresponds to day-to-day fatigue and fatigue during task performance. (shrink)

Cultural effects can influence the results of causal genetic analyses, such as Mendelian randomisation, but the potential influences of culture on genotype–phenotype associations are not currently well understood. Different genetic variants could be associated with different phenotypes in different populations, or culture could confound or influence the direction of the association between genotypes and phenotypes in different populations.

Self-criticism is a trait associated with increased psychopathology, but self-criticism is also a personality state reflecting an action that people do in moments of time. In the current study, we explored factors associated with heightened self-criticism in daily life. Participants (N = 197) received five random prompts per day for one week on their mobile phones, where they reported their current affect (negative and positive affect), willpower self-efficacy, distress intolerance, degree of support and criticism from others, current context (location, activity, (...) hunger, tiredness) and momentary self-criticism. We first demonstrated that self-criticism varies over time and across contexts, and is associated with heightened trait self-criticism. Then, using multilevel modelling, we explored the contextual factors associated with greater self-criticism. We found that self-criticism was higher when people were at home, and more tired. We also found higher self-criticism to be associated with greater negative and lower positive affect, greater distress intolerance, lower willpower and greater perceived criticism from others. In addition, self-criticism predicted subsequent distress intolerance, willpower and positive affect in lagged analyses. This study provides evidence that both environmental and psychological factors are associated with the dynamics of self-critical thoughts. (shrink)

Academic dishonesty, including cheating and plagiarism, is on the rise in colleges, particularly among engineering students. While students decide to engage in these behaviors for many different reasons, academic integrity training can help improve their understanding of ethical decision making. The two studies outlined in this paper assess the effectiveness of an online module in increasing academic integrity among first semester engineering students. Study 1 tested the effectiveness of an academic honesty tutorial by using a between groups design with a (...) Time 1- and Time 2-test. An academic honesty quiz assessed participants’ knowledge at both time points. Study 2, which incorporated an improved version of the module and quiz, utilized a between groups design with three assessment time points. The additional Time 3-test allowed researchers to test for retention of information. Results were analyzed using ANCOVA and t tests. In Study 1, the experimental group exhibited significant improvement on the plagiarism items, but not the total score. However, at Time 2 there was no significant difference between groups after controlling for Time 1 scores. In Study 2, between- and within-group analyses suggest there was a significant improvement in total scores, but not plagiarism scores, after exposure to the tutorial. Overall, the academic integrity module impacted participants as evidenced by changes in total score and on specific plagiarism items. Although future implementation of the tutorial and quiz would benefit from modifications to reduce ceiling effects and improve assessment of knowledge, the results suggest such tutorial may be one valuable element in a systems approach to improving the academic integrity of engineering students. (shrink)

Human languages typically employ a variety of spatial metaphors for time (e.g., “I'm looking forward to the weekend”). The metaphorical grounding of time in space is also evident in gesture. The gestures that are performed when talking about time bolster the view that people sometimes think about regions of time as if they were locations in space. However, almost nothing is known about the development of metaphorical gestures for time, despite keen interest in the origins of space–time metaphors. In this (...) study, we examined the gestures that English‐speaking 6‐to‐7‐year‐olds, 9‐to‐11‐year‐olds, 13‐to‐15‐year‐olds, and adults produced when talking about time. Participants were asked to explain the difference between pairs of temporal adverbs (e.g., “tomorrow” versus “yesterday”) and to use their hands while doing so. There was a gradual increase across age groups in the propensity to produce spatial metaphorical gestures when talking about time. However, even a substantial majority of 6‐to‐7‐year‐old children produced a spatial gesture on at least one occasion. Overall, participants produced fewer gestures in the sagittal (front‐back) axis than in the lateral (left‐right) axis, and this was particularly true for the youngest children and adolescents. Gestures that were incongruent with the prevailing norms of space–time mappings among English speakers (leftward and backward for past; rightward and forward for future) gradually decreased with increasing age. This was true for both the lateral and sagittal axis. This study highlights the importance of metaphoricity in children's understanding of time. It also suggests that, by 6 to 7 years of age, culturally determined representations of time have a strong influence on children's spatial metaphorical gestures. (shrink)

Background:The belief that we can control our thoughts is not inevitably adaptive, particularly when it fuels mental control activities that have ironic unintended consequences. The conviction that the mind can and should be controlled can prompt people to suppress unwanted thoughts, and so can set the stage for the intrusive return of those very thoughts. An important question is whether or not these beliefs about the control of thoughts can be reduced experimentally. One possibility is that behavioral experiments aimed at (...) revealing the ironic return of suppressed thoughts might create a lesson that could reduce unrealistic beliefs about the control of thoughts. Aims: The present research assessed the influence of the thought suppression demonstration on beliefs about the control of thoughts in a non-clinical sample, and among individuals with obsessive-compulsive disorder (OCD). Method: In Study 1, we assessed the effect of the thought suppression demonstration on beliefs about the control of thoughts among low and high obsessive individuals in the non-clinical population (N= 62). In Study 2, we conducted a similar study with individuals with OCD (N= 29). Results: Results suggest that high obsessive individuals in the non-clinical population are able to learn the futility of suppression through.. (shrink)

De Dreu and Gross's distinction between attack and defense is complicated in real-world conflicts because competing leaders construe their position as one of defense, and power imbalances place status quo challengers in a defensive position. Their account of defense as vigilant avoidance is incomplete because it avoids a reference to anger which transforms anxious avoidance into collective and unified action.

While pharmaceutical industry involvement in producing, interpreting, and regulating medical knowledge and practice is widely accepted and believed to promote medical innovation, industry-favouring biases may result in prioritizing corporate profit above public health. Using diabetes as our example, we review successive changes over forty years in screening, diagnosis, and treatment guidelines for type 2 diabetes and prediabetes, which have dramatically expanded the population prescribed diabetes drugs, generating a billion-dollar market. We argue that these guideline recommendations have emerged under pervasive industry (...) influence and persisted, despite weak evidence for their health benefits and indications of serious adverse effects associated with many of the drugs they recommend. We consider pharmaceutical industry conflicts of interest in some of the research and publications supporting these revisions, and in related standard-setting committees and oversight panels. We raise concern over the long-term impact of these multifaceted involvements. Rather than accept industry conflicts of interest as normal, needing only to be monitored and managed, we suggest challenging that normalcy, and ask: what are the real costs of tolerating such industry participation? We urge the development of a broader focus to fully understand and curtail the systemic nature of industry’s influence over medical knowledge and practice. (shrink)

A growing volume of research from global data demonstrates that institutional care under conditions of deprivation is profoundly damaging to children, particularly during the critical early years of development. However, how these individuals develop over a life course remains unclear. This study uses data from a survey on the health and development of 420 children mostly under the age of three, placed in 12 infant care institutions between 1958 and 1961 in Zurich, Switzerland. The children exhibited significant delays in cognitive, (...) social, and motor development in the first years of life. Moreover, a follow-up of a subsample of 143 children about 10 years later revealed persistent difficulties, including depression, school related-problems, and stereotypies. Between 2019 and 2021, these formerly institutionalized study participants were located through the Swiss population registry and invited to participate once again in the research project. Now in their early sixties, they are studied for their health, further development, and life-course trajectories. A mixed-methods approach using questionnaires, neuropsychological assessments, and narrative biographical interviews was implemented by a multidisciplinary team. Combining prospective and retrospective data with standardized quantitative and biographical qualitative data allows a rich reconstruction of life histories. The availability of a community sample from the same geographic location, the 1954–1961 cohort of the Zurich Longitudinal Studies, described in detail in a paper in this issue, enables comparison with an unaffected cohort. This article describes the study design and study participants in detail and discusses the potential and limitations of a comparison with a community sample. It outlines a set of challenges and solutions encountered in the process of a lifespan longitudinal study from early childhood into the cusp of old age with a potentially vulnerable sample and summarizes the lessons learned along the way. (shrink)

This paper is going to explore the adverse effects of exposure to combat death on medics’ holistic well-being, which, if ignored could decrease individual readiness and negatively impact the mission. We rely on the experience of United States Air Force Special Operation Surgical Teams (AF SOST) whose exposure to mass casualty scenarios in austere environments could serve as approximations of conditions of future battlefields. Over the past two decades, the ability to deliver advanced medical care on and off the battlefield (...) along with a rapid casualty evacuation platform has allowed for unprecedented survival rates exceeding 90%. While laudable, these medical achievements have also set up a casualty management paradigm in which medical decision-making singularly focuses on life-saving care. Confronting peer-peer adversaries in large scale combat operations (LSCO) on a multi-domain battlefield will make casualty management frighteningly more complex by introducing major infrastructural, personnel, and resource constraints. When considering the high number of casualties expected in LSCO alongside enormous limitations in medical resource and resupply capability, the current casualty management paradigm will not be sustainable. The resource constrained environment in LSCO will shift medical decision-making away from a singular focus on life-saving care to triage, which hinges on the ability to determine futile medical interventions—a skill that has been lost in the past two generation of combat medics. As such, a broad ethical challenge that arises in preparation for LSCO is the need to set new expectations concerning dying and death. However, medical decision-making focused on death and dying has not been explicitly addressed in military medical training, research, or policy. Relying on a body of literature known as terror management theory (TMT) and ethnographic data from our study with AF SOST medics, we are going to argue that it is important to expose medics to death in mass casualty and triage training. (shrink)

The concept of fitness is central to evolutionary biology. Models of evolutionary change typically use some quantity called “fitness” which measures an organism’s reproductive success. But what exactly does it mean that fitness is such a measure? In what follows, we look at the interplay between abstract evolutionary models and quantitative measures of fitness and develop a measurement-theoretic perspective on fitness in order to explore what makes certain measures of fitness significant.

Supporting children to successfully transition from primary to secondary school is of utmost importance for several reasons, including to prevent future emotional and behavioural problems. Level Up is a novel, UK-based intervention consisting of five online group sessions, straddling the summer holidays, and providing at-risk children and their parents/carers with skills to manage their behaviour, emotions, and relationships to support their transition to secondary school. A prior evaluation of Level Up reported a need to better describe the mechanisms of change. (...) This study therefore evaluated the experiences of children and their parents/carers regarding the facilitators and barriers to engagement and change, and the perceived impact. Fourteen children and 17 parents/carers were interviewed. Identified barriers and facilitators were: (1) Having a safe, supportive, and fun space, (2) Learning through connection, (3) A family approach, (4) Problematic group dynamics, and (5) Connecting through video calls. Perceived impact was described as: (1) Empowering children, (2) Supporting children socially, (3) Supporting parents and carers in their parenting role, and (4) Supporting a successful transition to secondary school. Another theme (5) describes some families’ experiences of limited impact. These findings can be used to better understand how to support children in their school transition. (shrink)

The current study investigates whether self-talk phrases can influence behavior in Ultimatum Games. In our three self-talk treatments, participants were instructed to tell themselves (i) to keep their own interests in mind, (ii) to also think of the other person, or (iii) to take some time to contemplate their decision. We investigate how such so-called experimenter-determined strategic self-talk phrases affect behavior and emotions in comparison to a control treatment without instructed self-talk. The results demonstrate that other-focused self-talk can nudge proposers (...) towards fair behavior, as offers were higher in this group than in the other conditions. For responders, self-talk tended to increase acceptance rates of unfair offers as compared to the condition without self-talk. This effect is significant for both other-focused and contemplation-inducing self-talk but not for self-focused self-talk. In the self-focused condition, responders were most dissatisfied with unfair offers. These findings suggest that use of self-talk can increase acceptance rates in responders, and that focusing on personal interests can undermine this effect as it negatively impacts the responders’ emotional experience. In sum, our study shows that strategic self-talk interventions can be used to affect behavior in bargaining situations. (shrink)

Previous studies have shown cognitive task performance to be affected by tinnitus severity, but also that the literature is conflicted. This study sought to identify neuroticism as a possible confound, since severe tinnitus distress is associated with higher levels of neuroticism. A total of 78 participants undertook two cognitive tasks. It was found that when undertaking a Stroop paradigm, controlling for neuroticism rendered previously significant results not significant. It was also found that neuroticism was not a significant covariate for a (...) change blindness task. Gender, age, anxiety, and depression were all controlled for, and future implications for the literature discussed. (shrink)

This text departs from a contradictory claim in deaf studies and sound studies: both disciplines describe a hierarchical regime of the sensible – visuocentrism and audiocentrism – which they try to counter with conceptualisations as “acoustemology” or “deaf gain.” However, as we argue, they both thereby erect what they claim to overcome: a sensual regime that privileges one sense over another and a restricted conception of subjectivity deriving from it. First, we draw a philosophical line in the critique of sensual (...) regimes. Then we propose a figure for the transcendence of the separation of the sensible: in re-reading of the myth of Odysseus and the sirens, we engage various examples from literature, art, and acoustics to describe sirens as a mythological and technical archetype of the transcendence of the sensual regime, as well as reified subjectivity. The question, then, is not how to escape the sirens, but how they can be approached. It is necessary, we argue, for sound studies to develop a critical self-consciousness of its own restricted concepts in order to move from sonic thinking towards a sirenic thinking. (shrink)

Both unipolar and bipolar depression have been linked with impairments in executive functioning. In particular, mood symptom severity is associated with differences in common EF, a latent measure of general EF abilities. The relationship between mood disorders and EF is particularly salient in adolescence and young adulthood when the ongoing development of EF intersects with a higher risk of mood disorder onset. However, it remains unclear if common EF impairments have associations with specific symptom dimensions of mood pathology such as (...) blunted positive affect, mood instability, or physiological arousal, or if differences in common EF more broadly relate to what is shared across various symptom domains, such as general negative affect or distress. To address this question, bifactor models can be applied to simultaneously examine the shared and unique contributions of particular mood symptom dimensions. However, no studies to our knowledge have examined bifactor models of mood symptoms in relation to measures of common EF. This study examined associations between common EF and general vs. specific symptom dimensions using structural equation modeling in adolescents and young adults with varying severity of mood symptoms. A General Depression factor capturing shared variance across symptoms statistically predicted lower Common EF. Additionally, a factor specific to physiological arousal was associated with lower Common EF. Anhedonia-specific and Mania-specific factors were not significantly related to Common EF. Altogether, these results indicate that deficits in common EF are driven by, or reflect, general features of mood pathology that are shared across symptom dimensions but are also specifically associated with physiological arousal. (shrink)

Epistemic injustice is defined by Miranda Fricker as injustice done to people specifically in their capacities as knowers. Fricker argues that this injustice can be either testimonial or hermeneutical in character. A hearer commits testimonial injustice against a speaker by assigning unfairly little credibility to the speaker’s testimony. Hermeneutical injustice exists in a society when the society lacks the concepts necessary for members of a group to understand their social experiences. We argue that epistemic injustice is necessary to permit the (...) functioning of race-based chattel slavery and that this necessity is illustrated in slave narratives. The testimonies of slave narratives like those of Frederick Douglass, Olaudah Equiano, Harriet Jacobs, and Mary Prince identify and transform a culture of race-based epistemic hermeneutic and testimonial injustice. Through telling their stories, these agents establish their capacity as knowers and thus resist the epistemic injustice that undergirds the oppressive system of race-based chattel slavery. The authors of slave narratives not only identify race-based epistemic injustice, but actively fight against it. (shrink)