Human microbiome research makes causal connections between entire microbial communities and a wide array of traits that range from physiological diseases to psychological states. To evaluate these causal claims, we first examine a well-known single-microbe causal explanation: of Helicobacter pylori causing ulcers. This apparently straightforward causal explanation is not so simple, however. It does not achieve a key explanatory standard in microbiology, of Koch’s postulates, which rely on manipulations of single-microorganism cultures to infer causal relationships to disease. When Koch’s postulates (...) are framed by an interventionist causal framework, it is clearer what the H. pylori explanation achieves and where its explanatory strengths lie. After assessing this ‘simple’, single-microbe case, we apply the interventionist framework to two key areas of microbiome research, in which obesity and mental health states are purportedly explained by microbiomes. Despite the experimental data available, interventionist criteria for explanation show that many of the causal claims generated by microbiome research are weak or misleading. We focus on the stability, specificity and proportionality of proposed microbiome causal explanations, and evaluate how effectively these dimensions of causal explanation are achieved in some promising avenues of research. We suggest some conceptual and explanatory strategies to improve how causal claims about microbiomes are made. (shrink)

Human microbiome research makes causal connections between entire microbial communities and a wide array of traits that range from physiological diseases to psychological states. To evaluate these causal claims, we first examine a well-known single-microbe causal explanation: of Helicobacter pylori causing ulcers. This apparently straightforward causal explanation is not so simple, however. It does not achieve a key explanatory standard in microbiology, of Koch’s postulates, which rely on manipulations of single-microorganism cultures to infer causal relationships to disease. When Koch’s postulates (...) are framed by an interventionist causal framework, it is clearer what the H. pylori explanation achieves and where its explanatory strengths lie. After assessing this ‘simple’, single-microbe case, we apply the interventionist framework to two key areas of microbiome research, in which obesity and mental health states are purportedly explained by microbiomes. Despite the experimental data available, interventionist criteria for explanation show that many of the causal claims generated by microbiome research are weak or misleading. We focus on the stability, specificity and proportionality of proposed microbiome causal explanations, and evaluate how effectively these dimensions of causal explanation are achieved in some promising avenues of research. We suggest some conceptual and explanatory strategies to improve how causal claims about microbiomes are made. (shrink)

Given the primary mandate for institutional review boards (IRBs) to protect potential participants from harm, the egregious history of research abuses, and the fact that there is no mention of incl...

Some individuals facing dementia contemplate hastening their own death: weighing the possibility of living longer with dementia against the alternative of dying sooner but avoiding the later stages of cognitive and functional impairment. This weighing resonates with an ethical and legal consensus in the United States that individuals can voluntarily choose to forgo life‐sustaining interventions and also that medical professionals can support these choices even when they will result in an earlier death. For these reasons, whether and how a terminally (...) ill individual can choose to control the timing of their death is a topic that cannot be avoided when considering the dementia trajectory. With a focus on the U.S. context, this landscape review considers the status of provisions that would legally permit people facing dementia to hasten death with appropriate support from medical professionals. This review can be used to plan and guide clinical and legal practitioner discussion and policy development concerning evolving questions not fully covered by existing medical decision‐making provisions. (shrink)

Stigma can influence the prevention and identification of fetal alcohol spectrum disorder, a leading cause of developmental delay in North America. Understanding the effects of public health practices and policies on stigma is imperative. We reviewed social science and biomedical literatures to understand the nature of stigma in FASD and its relevance from an ethics standpoint in matters of health practices and policies. We propose a descriptive model of stigma in FASD and note current knowledge gaps; discuss the ethical implications (...) of stigma based on two distinct criteria ; and describe two cases and the concerns associated with inadvertent stigmatization by public health initiatives for FASD. We recommend further empirical and ethical analyses to examine whether public health policies and practices inadvertently stigmatize and impact the success of public health initiatives and programs for FASD. (shrink)

Institutional Review Board decisions hinge on the availability and interpretation of information. This is demonstrated by the following well-known historical example. In 2001, 24-year-old Ellen Roche died from respiratory distress and organ failure as a result of her participation in a study at Johns Hopkins Asthma and Allergy Center. The non-therapeutic physiological study, “Mechanisms of Deep Inspiration-Induced Airway Relaxation,” was designed to examine airway hyperresponsiveness in healthy individuals in order to better understand the pathophysiology of asthma. Participants inhaled hexamethonium, a (...) chemical ganglionic blocker that was not FDA-approved for use as specified in the experimental protocol. Risks of inhaling hexamethonium, including lung damage, had been reported in the 1950s and ‘60s. An investigation conducted after Roche's death determined that the study's principal investigator had failed to adequately search the medical literature; the protocol submitted for IRB review cited articles indexed in online literature databases that went back only as far as the 1970s. (shrink)

Volume 19, Issue 9, September 2019, Page 62-64.

Volume 20, Issue 5, June 2020, Page 28-30.

In this commentary, we set out the specifics of how Glowacki's game theoretical framework for the evolution of peace could be incorporated within broader cultural evolutionary approaches. We outline a formal proposal for prisoner's dilemma games investigating raid-based conflict. We also centre an ethnographic lens to understand the norms surrounding war and peace in intergroup interactions in small-scale communities.

Climate change is a wicked problem with causes and consequences overlapping with other wicked problems and no single solution (Hulme 2015). For example, the frequent droughts associated with climate change exacerbate another major problem facing humanity as we enter the Anthropocene: how to produce adequate food to feed a growing population without increasing pollution or “more food with low pollution (MoFoLoPo)” (Davidson et al. 2015). Soils represent an intersection of these two wicked problems, because they are integral to food production (...) through agriculture and also are an important component of global climate models. Recent focus in the field of soil carbon cycling has facilitated a transformation in our understanding of the processes that control this important resource. This understanding is critical to responding to both wicked problems. (shrink)

Insufficient attention has been paid to the ways in which Newtonian conceptualizations of time encourage the view in contemporary psychology that only efficient causal explanations are viable, explanations that ultimately render meaningful, purposive, morally rich human actions and relationships illusory. In short, psychology’s pervasive adoption of Newtonian assumptions about time and causation renders the discipline incapable of understanding human behavior, its primary focus of study, in any but fundamentally inhuman ways. This paper aims (1) to provide a critique of the (...) Newtonian conception of time and its commitment to efficient causality, particularly as commonly present in contemporary psychological theory and practice, and (2) to examine the phenomenological account of time provided in the work of Emmanuel Levinas. Specifically, we will explore some of the ways in which Levinas’ account of time as fundamentally intersubjective provides an alternative conceptual grounding for understanding the therapeutic relationship as one of infinite ethical responsibility. (shrink)

In the target article “Promoting Ethical Payment in Human Infection Challenge Studies,” Fernandez Lynch et al. call for more information sharing about research payment amounts to study parti...

This article investigates the ways in which discourses and experiences of health and healing have shaped the development of contemporary dance in France. It confronts the problem of how to situate contemporary dance in relation to other dance genres and suggests Robert Desjarlais’ concept of the ‘aesthetic of experience’ as a helpful framework for understanding the ways in which technique and virtuosity operate differently in contemporary dance than in other dance forms. The article is ethnographic and historical and attempts to (...) create a dialogue between dance studies and medical anthropology. The ethnographic and historical material has three parts. First, I offer an analysis of the cultural idiom of illness as blocageand argue that contemporary dancers in Aix-en-Provence experience their work as a form of healing or dÈblocage. Next, I show how two historical and political events in France led to the promotion of dance as a means of social reform: (1) the Situationist art movement of the 1960s and its idea of ‘awakening’ society through public art; and (2) the renovation of the French Ministry of Culture in 1982 and its subsequent promotion of contemporary dance in state-funded community outreach projects in the 1980s. Finally, drawing on rich narratives from fieldwork interviews, I define awareness, expression and presence as the primary technical elements of contemporary dance in Aix-en-Provence, France, in 2002, and explain their relationship to the notion of ‘dance as l'intervention’ that has grown out of the historical context of contemporary dance in France. (shrink)

Stereotype threat—a situational context in which individuals are concerned about confirming a negative stereotype—is often shown to impact test performance, with one hypothesized mechanism being that cognitive resources are temporarily co-opted by intrusive thoughts and worries, leading individuals to underperform despite high content knowledge and ability. We test here whether stereotype threat may also impact initial student learning and knowledge formation when experienced prior to instruction. Predominantly African American fifth-grade students provided either their race or the date before a videotaped, (...) conceptually demanding mathematics lesson. Students who gave their race retained less learning over time, enjoyed the lesson less, reported a diminished desire to learn more, and were less likely to choose to engage in an optional math activity. The detrimental impact was greatest among students with high baseline cognitive resources. While stereotype threat has been well documented to harm test performance, the finding that effects extend to initial learning suggests that stereotype threat's contribution to achievement gaps may be greatly underestimated. (shrink)

Graphical AbstractBy combining phylogeography and zooarchaeology, the spatial distribution and temporal dynamics within species lineages can be reconstructed. Both approaches should be used with four rat species (black, Asian house, Pacific, and brown) to understand the minimum dates of commensalism, urbanization dynamics, and connections among human societies. More details can be found in article number 1900160 by Emily E. Puckett et al.

« Mais pourquoi diable les humains, sur leur petite planète bleue, s’intéressent-ils à ce point à moi, qui ne suis qu’un extraterrestre? » : telle est la question que pose un E. T. parmi tant d’autres, depuis l’espace intersidéral, à une autrice de science-fiction qui a transformé ce genre littéraire qu’est le space opéra et à un astrophysicien qui est aussi le président du plus grand festival de sciences et de science-fiction en France : les Utopiales à Nantes.

OBJECTIVES: Early-emerging, temperamental differences in fear-related traits may be a heritable vulnerability factor for anxiety disorders. Previous research indicates that the serotonin transporter promoter region polymorphism is a candidate gene for such traits. METHODS: Associations between 5-HTTLPR genotype and indices of fearful child temperament, derived from maternal report and standardized laboratory observations, were examined in a community sample of 95 preschool-aged children. RESULTS: Children with one or more long alleles of the 5-HTTLPR gene were rated as significantly more nervous during (...) standardized laboratory tasks than children who were homozygous for the short alleles. Children homozygous for the short alleles were also rated as significantly shyer, by maternal report, than those with at least one copy of the long allele of the 5-HTTLPR gene. CONCLUSIONS: This study extends the literature linking the short alleles of the serotonin transporter promoter region polymorphism to fear and anxiety-related traits in early childhood and adulthood, and is one of very few studies to examine the molecular genetics of preschoolers' temperament using multiple measures of traits in a normative sample. (shrink)

Human microbiome research makes causal connections between entire microbial communities and a wide array of traits that range from physiological diseases to psychological states. To evaluate these causal claims, we first examine a well-known single-microbe causal explanation: of Helicobacter pylori causing ulcers. This apparently straightforward causal explanation is not so simple, however. It does not achieve a key explanatory standard in microbiology, of Koch’s postulates, which rely on manipulations of single-microorganism cultures to infer causal relationships to disease. When Koch’s postulates (...) are framed by an interventionist causal framework, it is clearer what the H. pylori explanation achieves and where its explanatory strengths lie. After assessing this ‘simple’, single-microbe case, we apply the interventionist framework to two key areas of microbiome research, in which obesity and mental health states are purportedly explained by microbiomes. Despite the experimental data available, interventionist criteria for explanation show that many of the causal claims generated by microbiome research are weak or misleading. We focus on the stability, specificity and proportionality of proposed microbiome causal explanations, and evaluate how effectively these dimensions of causal explanation are achieved in some promising avenues of research. We suggest some conceptual and explanatory strategies to improve how causal claims about microbiomes are made. (shrink)

Phylogeography and zooarchaeology are largely separate disciplines, yet each interrogates relationships between humans and commensal species. Knowledge gained about human history from studies of four commensal rats (Rattus rattus, R. tanezumi, R. exulans, and R. norvegicus) is outlined, and open questions about their spread alongside humans are identified. Limitations of phylogeographic and zooarchaeological studies are highlighted, then how integration would increase understanding of species’ demographic histories and resultant inferences about human societies is discussed. How rat expansions have informed the understanding (...) of human migration, urban settlements, trade networks, and intra‐ and interspecific competition is reviewed. Since each rat species is associated with different human societies, they identify unique ecological and historical/cultural conditions that influenced their expansion. Finally, priority research areas including nuclear genome based phylogeographies are identified using archaeological evidence to understand R. norvegicus expansion across China, multi‐wave colonization of R. rattus across Europe, and competition between R. rattus and R. norvegicus. (shrink)

Using medical advances to enhance human athletic, aesthetic, and cognitive performance, rather than to treat disease, has been controversial. Little is known about physicians? experiences, views, and attitudes in this regard. We surveyed a national sample of physicians to determine how often they prescribe enhancements, their views on using medicine for enhancement, and whether they would be willing to prescribe a series of potential interventions that might be considered enhancements. We find that many physicians occasionally prescribe enhancements, but doctors hold (...) nuanced and ambiguous views of these issues. Most express concerns about the potential effects of enhancements on social equity, yet many also believe specific enhancements that are safe and effective should be available but not covered by insurance. These apparently contradictory views might reflect inherent tensions between the values of equity and liberty, which could make crafting coherent social policies on medical enhancements challenging. [Supplementary materials are available for this article. Go to the publisher's online edition of American Journal of Bioethics for the following free supplemental resource(s): An additional table (Table 5) referred to on p. 5]. (shrink)

The stories in this volume shed light on the potential of narrative inquiry to fill gaps in knowledge, particularly given the mixed results of quantitative research on patient views of and experiences with genetic and genomic testing. Published studies investigate predictors of testing (particularly risk perceptions and worry); psychological and behavioral responses to testing; and potential impact on the health care system (e.g., when patients bring DTC genetic test results to their primary care provider). Interestingly, these themes did not dominate (...) the narratives published in this issue. Rather, these narratives included consistent themes of expectations and looking for answers; complex emotions; areas of contradiction and conflict; and family impact. More narrative research on patient experiences with genetic testing may fill gaps in knowledge regarding how patients define the benefits of testing, changes in psychological and emotional reactions to test results over time, and the impact of testing on families. (shrink)

In the year 1308, Cardinal Giacomo Colonna was a tremendously busy man. He had returned to Rome only a few years earlier in the aftermath of a devastating papal war waged against his family by Boniface VIII. The papal court had been absent from the city for years, leaving an administrative void in Rome as it established itself first in Poitiers, then in Avignon from 1308 under the leadership of the Gascon pope Clement V. In 1306 Giacomo was fully reinstated (...) to the cardinalate, and set about rebuilding his family's fortunes and reputation, as well as a number of the city's churches. He commissioned a new mosaic facade for the basilica of Santa Maria Maggiore, and in 1308 he oversaw repairs... (shrink)

Wisdom is a multi-component trait that is important for mental health and well-being. In this study, we sought to understand gender differences in relative strengths in wisdom. A total of 659 individuals aged 27–103 years completed surveys including the 3-Dimensional Wisdom Scale and the San Diego Wisdom Scale. Analyses assessed gender differences in wisdom and gender’s moderating effect on the relationship between wisdom and associated constructs including depression, loneliness, well-being, optimism, and resilience. Women scored higher on average on the 3D-WS (...) but not on the SD-WISE. Women scored higher on compassion-related domains and on SD-WISE Self-Reflection. Men scored higher on cognitive-related domains and on SD-WISE Emotion Regulation. There was no impact of gender on the relationships between wisdom and associated constructs. Women and men have different relative strengths in wisdom, likely driven by sociocultural and biological factors. Tailoring wisdom interventions to individuals based on their profiles is an important next step. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Re-examining Empirical Data on Conflicts of Interest Through the Lens of Personal NarrativesEmily E. Anderson and Elena M. KrausIntroductionThe personal stories submitted by physicians and researchers for this symposium add much–needed dimension to conversations on conflicts of interest in medicine and research. Narratives from individuals living with conflicts of interest can serve as a unique lens through which to consider psychological and economic theories and survey data on physician (...) and patient views. In our reading of these personal narratives, we identified four primary themes that will serve as springboards for our commentary. We aim to triangulate clusters of meaning drawn from the narratives with relevant data from published empirical studies and identify gaps in knowledge where more research is needed. These themes are: the unique environments of medicine and research; weighing the potential benefits of conflicts of interest against the risks; conflict of interest management; and the roles and responsibilities of diverse stakeholder groups.The Unique Challenges of the Medical and Research EnvironmentsThe reflections of the narrative authors draw attention to many of the unique environmental aspects of medicine and medical research that make physicians and researchers especially vulnerable to conflicts of interest. Conflicts of interest may be more ubiquitous in medicine than in any other industry (Kassirer, 2006). As the narratives demonstrate, conflicts of interest emerge across a range of health care delivery and research activities. Surveys have shown that 94 percent of physicians have some kind of relationship with industry (Campbell, Gruen, Mountford, et al., 2007). There is also evidence that physician interactions with medical industry begin early and are a regular part of a physician’s professional practice along the career continuum (Wazana, 2000).Medicine as a profession is distinct from banking or law. It is often said that medicine is an art; in treating patients, creative individualized solutions and gut instinct are as (if not more) important than the application of scientific knowledge. Uncertainty surrounds medical decision making. There is limited precision with respect to diagnoses and prognoses, limited data regarding the effectiveness of many treatments, and a range of patient values and preferences. Because of this uncertainty, rules about practice standards, especially with respect to avoidance and management of conflicts of interest, cannot be as explicit as they are in law or business. As demonstrated by the story presented by Sal Cruz–Flores, research and practice often intersect. And, there is no system in greater need of reform—and no system about which there are more divergent opinions as to what shape that reform should take—than the United States health care [End Page 91] system. The narratives of Tony Mikulec, Govind Nagaldinne, and David M. Zientek demonstrate how various aspects of the structure of healthcare service provision and third–party payer arrangements have the potential to harm patients. Conflicts of interest comprise more than relationships with pharmaceutical and medical device manufacturers.The narratives of Laura Jean Bierut and David M. Zientek also discuss examples of conflicts of interest that arise from factors beyond relationships with industry or the direct potential for financial gain. This may be somewhat unique to the medical milieu. Non-financial conflicts such as a desire for the prestige bestowed upon scientists who make key discoveries, a requirement to publish for tenure and promotion, the need to maintain one’s license or other privileges, or simply the pressure of a competitive environment can influence physician and researcher behavior. As noted by Bierut, more research on how to identify and manage non-financial conflicts is needed.The Potential Benefits and Harms of Conflicts of InterestConflicts of interest are usually presented in a negative light, particularly those that involve physician relationships with the pharmaceutical industry. To “have a conflict of interest” is to be in a situation or role where there is potential for personal interests to be prioritized over professional responsibilities. However, in terms of public perception, it seems that conflicts of interest have become almost synonymous with wrongdoing. Perhaps this is due to the barrage of media reports during the last decade on significant harms caused by financial conflicts of interest in business, journalism, and sports as well as in medicine (Steinbrook, 2004). Amidst... (shrink)

This book provides in-depth analyses of a wide range of topics surrounding ethical issues in community and patient stakeholder–engaged health research, and highlights where consensus exists, is emerging, or remains elusive. Topics in this book cover the history of stakeholder engagement in health research; how codes of ethics and regulations have (or have not) addressed stakeholder engagement; how to promote equitable collaboration; the ethical perspectives of different stakeholders; and the unique challenges posed by stakeholder- engaged research to the protection of (...) human research participants and the research ethics review process. The book includes discussion of unique issues that arise in stakeholder engagement relevant to different populations, settings, and research designs. This book is relevant for anyone with a role or interest in stakeholder-engaged research, including patient and community research partners; academic researchers; research ethics scholars and educators; and funders. (shrink)

Only somewhat recently has a specific literature emerged focused on the ethics of engaging patient and community stakeholders in health research. This literature is informed by a broad range of disciplinary frameworks and norms. It also overlaps with – and diverges from – traditional research ethics scholarship in interesting and important ways. This volume is an effort to bring together, in one place, important perspectives on the ethics of stakeholder engagement in health research. Here, ethics, patient and community stakeholders, and (...) health-related research are all conceptualized broadly. (shrink)

In order to consider how best to address relationship concerns with potential research participants arising in this study, we will first describe unique features...

Given that many clinical research studies struggle to meet their recruitment goals, researchers are eager to identify and employ strategies that will maximize reach to eligible and int...

In lieu of an abstract, here is a brief excerpt of the content:Grand Manner Aesthetics in LandscapeFrom Canvas to CelluloidEmily E. Auger (bio)Popular films about the environment and related human and material resource issues, particularly colonialism, tend to enhance the appeal of their subject matter by aesthetically transforming it according to audience preferences and tastes. Such mediating strategies are perhaps too familiar to contemporary artists of all types who would prefer to work beyond the limits of what their readers or (...) viewers are prepared to tolerate as entertainment, but the particular emphases and accommodations made by film artists to convey messages about the environment are little changed from those strategies used by painters over the past three centuries to a similar end. The methods by which environmental issues are aestheticized in late-twentieth-century film is directly and historically related to those established for grand manner painters by Nicholas Poussin (1594-1665) and taught at the French academy from the seventeenth through the nineteenth centuries. That these fundamentals were part of the training of artists who would be willing and able to enhance the glory of Louis XIV's absolutist monarchy seems not to have undermined the popular enthusiasm their association with the "classical" past generated outside of France. Thus, the grand manner ideal was repeated, elaborated, and adapted by subsequent British and American artists, teachers, and aestheticians, both amateur and professional, including Joshua Reynolds (1723-92), president of the British academy; theoretician Edmund Burke (1729-97); and such American painters as Benjamin West (1738-1820), Thomas Cole (1801-48), Frederic Church (1826-1900), and Albert Bierstadt (1830-1902).Examples of filmic adaptations of grand manner aesthetics considered here include English director John Boorman's The Emerald Forest (1985) and Anglo-French director Roland Joffé's The Mission (1986), both British productions; Kevin Costner's Dances with Wolves (1990) and John McTiernan's [End Page 96] Medicine Man (1992), both American productions with American directors; and Australian director Bruce Beresford's Black Robe (1991), a Canadian/Australian production based on Irish-born, Canadian novelist Brian Moore's best-selling novel of the same title (1985). While it might be argued that these films merely show the adaptation of academy-based grand manner ideals and principles to new imperialist interests, this article demonstrates how they educate and draw public sympathy to global environmental concerns, albeit with reference to a recognizably Western aesthetic tradition. Thus, the interest of this study to educators and students of the visual arts is twofold: first, it demonstrates the continued adaptation and application of aesthetic principles originally developed in the seventeenth century to a technology-based medium; and second, it shows how those aesthetic principles are currently applied in film to direct and modulate public opinion on matters well beyond the domain of pure or theoretical aesthetics.The grand manner aesthetic, first defined with reference to seventeenth-century painting and still apparent in twentieth-century film, is largely attributable to Poussin since he was an artist who wrote—and wrote well—about his understanding of artistic quality and priorities. He was deeply committed to classicism; he thought the elements of a painting should be idealized rather than realistic and particularized, that those elements should be clearly delineated in a linear manner, that exotic subjects and excessive color should be avoided as both appeal too much to the senses and not enough to the mind, and that figures should always predominate over landscape. Poussin's ideals became the model for students training at the French Academy, an institution officially formed in 1648 under the direct control of the government. Aspiring academicians were exhorted to produce images that were usually composites of the better, and sometimes imagined, aspects of the appearance, character, and deeds of the fictional and historical people, events, and locations that were their subjects. They were never allowed to forgot the hierarchy of value that placed genre painting forever below history painting, yet it cannot have escaped their notice that a certain number of well-executed examples of the lowly still life, domestic interior, and picturesque landscape on the exhibition walls made the "grandness" of more ambitious works more apparent by contrast.The French Academy soon became the envy of foreign upper-level bureaucrats cognizant... (shrink)

In this article we describe our approach to understanding wrongdoing in medical research and practice, which involves the statistical analysis of coded data from a large set of published cases. We focus on understanding the environmental factors that predict the kind and the severity of wrongdoing in medicine. Through review of empirical and theoretical literature, consultation with experts, the application of criminological theory, and ongoing analysis of our first 60 cases, we hypothesize that 10 contextual features of the medical environment (...) (including financial rewards, oversight failures, and patients belonging to vulnerable groups) may contribute to professional wrongdoing. We define each variable, examine data supporting our hypothesis, and present a brief case synopsis from our study that illustrates the potential influence of the variable. Finally, we discuss limitations of the resulting framework and directions for future research. (shrink)