The Dutch policy objective of a fully sustainable livestock sector without mutilations by 2023 is not compatible with the routine practice of tail docking to minimize the risk of tail biting. To examine farmer attitudes towards docking, a telephone survey was conducted among 487 conventional and 33 organic Dutch pig farmers. “Biting” (of tails, ears, or limbs) was identified by the farmers as a main welfare problem in pig farming. About half of the farmers reported to have no tail biting (...) problems in their own herd. When farmers did report problems, they most often reported figures between 1 and 5 % of the animals. High incidences of tail biting were anticipated when trying to keep undocked pigs. Enrichment materials used in the conventional sector included mainly chains (52–63 % of the farms) and hanging rubber or plastic balls (22–30 %). Straw, sawdust, or wood shavings was hardly provided in conventional pig farming (2–3 %), in contrast to organic farming (88–100 % of farms). Conventional pig farmers feel a curly tail is not very important for sustainable pig farming. They consider enrichment to be less effective and tail docking to be less stressful for them and their piglets than their organic colleagues do. Pig farmers identified climate as a main risk factor for tail biting as opposed to enrichment. The objective of reducing routine tail docking requires solutions for dealing with tail biting problems at the farm level. In this process, transfer of scientific knowledge about enrichment materials and other measures to prevent and cure tail biting is critical, as is a change in farmer attitudes and awareness of the moral issues involved. (shrink)

The Dutch policy objective of a fully sustainable livestock sector without mutilations by 2023 is not compatible with the routine practice of tail docking to minimize the risk of tail biting. To examine farmer attitudes towards docking, a telephone survey was conducted among 487 conventional and 33 organic Dutch pig farmers. “Biting” (of tails, ears, or limbs) was identified by the farmers as a main welfare problem in pig farming. About half of the farmers reported to have no tail biting (...) problems in their own herd. When farmers did report problems, they most often reported figures between 1 and 5 % of the animals. High incidences of tail biting were anticipated when trying to keep undocked pigs. Enrichment materials used in the conventional sector included mainly chains (52–63 % of the farms) and hanging rubber or plastic balls (22–30 %). Straw, sawdust, or wood shavings was hardly provided in conventional pig farming (2–3 %), in contrast to organic farming (88–100 % of farms). Conventional pig farmers feel a curly tail is not very important for sustainable pig farming. They consider enrichment to be less effective and tail docking to be less stressful for them and their piglets than their organic colleagues do. Pig farmers identified climate as a main risk factor for tail biting as opposed to enrichment. The objective of reducing routine tail docking requires solutions for dealing with tail biting problems at the farm level. In this process, transfer of scientific knowledge about enrichment materials and other measures to prevent and cure tail biting is critical, as is a change in farmer attitudes and awareness of the moral issues involved. (shrink)

‘Serendipity’ is a category used to describe discoveries in science that occur at the intersection of chance and wisdom. In this paper, I argue for understanding serendipity in science as an emergent property of scientific discovery, describing an oblique relationship between the outcome of a discovery process and the intentions that drove it forward. The recognition of serendipity is correlated with an acknowledgment of the limits of expectations about potential sources of knowledge. I provide an analysis of serendipity in science (...) as a defense of this definition and its implications, drawing from theoretical and empirical research on experiences of serendipity as they occur in science and elsewhere. I focus on three interrelated features of serendipity in science. First, there are variations of serendipity. The process of serendipitous discovery can be complex. Second, a valuable outcome must be obtained before reflection upon the significance of the unexpected observation or event in respect to that outcome can take place. Therefore, serendipity is retrospectively categorized. Third, the primacy of epistemic expectations is elucidated. Finally, I place this analysis within discussions in philosophy of science regarding the impact of interpersonal competition upon the number and significance of scientific discoveries. Thus, the analysis of serendipity offered in this paper contributes to discussions about the social-epistemological aspects of scientific discovery and has normative implications for the structure of epistemically effective scientific communities. (shrink)

This chapter looks closely at the use of resilience as a value in pandemic discourses, and particularly at how it reflects the moral complexity of the situation the pandemic presents: an extended crisis where shocks and stressors interact and have an uncertain end. We review key aspects of how resilience has been conceptualised, generally speaking, focusing on its normative implications. Insofar as resilience is suggested as a goal, or used to evaluate individuals, groups and systems, the rhetorical use of resilience (...) in the pandemic has moral implications that we unpack. Asking questions such as resilience to what, of what, and for whom, drives our analysis of the multiple scales at which morally relevant factors must be considered, in terms of distance and certainty, and across space and over time. Further, we highlight the importance of particularly challenging, intersecting scales both within and beyond the pandemic, such as the interaction between other- and self-regarding concerns and the tension between transformation and conservation, as we consider when to take up opportunities for improving ourselves, our society and our systems, in times of extended crises and radical change. Given that a ‘return to normal’ is neither universally desirable nor likely, we recommend in this chapter ways to address resilience as a value that can shape approaches to policy and behaviour while also being explicit about the normative—evaluative and also prescriptive—implications of its use. (shrink)

What role does experience play in the development of face recognition? A growing body of evidence indicates that newborn brains need slowly changing visual experiences to develop accurate visual recognition abilities. All of the work supporting this “slowness constraint” on visual development comes from studies testing basic‐level object recognition. Here, we present the results of controlled‐rearing experiments that provide evidence for a slowness constraint on the development of face recognition, a prototypical subordinate‐level object recognition task. We found that (1) newborn (...) chicks can rapidly develop view‐invariant face recognition and (2) the development of this ability relies on experience with slowly moving faces. When chicks were reared with quickly moving faces, they built distorted face representations that largely lacked invariance to viewpoint changes, effectively “breaking” their face recognition abilities. These results provide causal evidence that slowly changing visual experiences play a critical role in the development of face recognition, akin to basic‐level object recognition. Thus, face recognition is not a hardwired property of vision but is learned rapidly as the visual system adapts to the temporal structure of the animal's visual environment. (shrink)

Executive functions (EFs) and impulsivity are dimensions of self-regulation that are both related to psychopathology. However, self-report measures of impulsivity and laboratory EF tasks typically display small correlations, and existing research indicates that impulsivity and EFs may tap separate aspects of self-regulation that independently statistically predict psychopathology in adulthood. However, relationships between EFs, impulsivity, and psychopathology may be different in childhood compared to adulthood. Here, we examine whether these patterns hold in the baseline assessment of the Adolescent Brain and Cognitive (...) Development (ABCD) sample, a national sample of over 11,000 children (including 749 twin pairs) ages 9–10 years. We examine the phenotypic and genetic relationships among latent variables for different components of EFs and multiple facets of impulsivity. Additionally, we assess how EFs and impulsivity relate to composite measures and latent variables of psychopathology derived from parent report. EFs were weakly correlated with impulsivity, and the strength varied by impulsivity facet, emphasizing their separability. We did not identify significant genetic and environmental correlations between EFs and impulsivity. Moreover, controlling for their small relationships with each other, both EFs and some facets of impulsivity statistically predicted an Externalizing factor, attention problems, and social problems, and twin analyses suggested these relationships were genetic in origin. These findings indicate that EFs and impulsivity represent phenotypically and genetically separable aspects of self-regulation that are both transdiagnostic correlates of psychopathology in childhood. (shrink)

ABSTRACT A triad approach to mentoring, involving an undergraduate student a graduate student and a faculty member, offers unique benefits to all involved. However, complexities and tensions within the triad also contribute to ethical dilemmas unique to this mentoring approach. The aims of this article are to review ethical dilemmas that members of the undergraduate-graduate-faculty triad may face when forming and navigating the triad, including a discussion of cultural considerations, and offer recommendations based on ethical guidelines in psychology Ethical Principles (...) of Psychologists and Code of Conduct. (shrink)

How do newborns learn to recognize objects? According to temporal learning models in computational neuroscience, the brain constructs object representations by extracting smoothly changing features from the environment. To date, however, it is unknown whether newborns depend on smoothly changing features to build invariant object representations. Here, we used an automated controlled-rearing method to examine whether visual experience with smoothly changing features facilitates the development of view-invariant object recognition in a newborn animal model—the domestic chick. When newborn chicks were reared (...) with a virtual object that moved smoothly over time, the chicks created view-invariant representations that were selective for object identity and tolerant to viewpoint changes. Conversely, when newborn chicks were reared with a temporally non-smooth object, the chicks developed less selectivity for identity features and less tolerance to viewpoint changes. These results provide evidence for a “smoothness constraint” on the development of invariant object recognition and indicate that newborns leverage the temporal smoothness of natural visual environments to build abstract mental models of objects. (shrink)

While resilience is a major concept in development, climate adaptation, and related domains, many doubts remain about how to interpret this term, its relationship with closely overlapping terms, or its normativity. One major view is that, while resilience originally was a descriptive concept denoting some adaptive property of ecosystems, subsequent applications to social contexts distorted its meaning and purpose by framing it as a transformative and normative quality. This article advances an alternative philosophical account based on the scrutiny of C.S. (...) Holling’s original work on resilience. We show that resilience had a central role among Holling’s proposals for reforming environmental science and management, and that Holling framed resilience as an ecosystem’s capacity of absorbing change and exploiting it for adapting or evolving, but also as the social ability of maintaining and opportunistically exploiting that natural capacity. Resilience therefore appears as a transformative social-ecological property that is normative in three ways: as an intrinsic ecological value, as a virtue of organizations or management styles, and as a virtuous understanding of human–nature relations. This interpretation accounts for the practical relevance of resilience, clarifies the relations between resilience and related terms, and is a firm ground for further normative work on resilience. (shrink)

Although researchers have investigated the impact of social isolation on well-being, the recent quarantines due to COVID-19 resulted in a social isolation environment that was unique to any examined in the past. Because sleep is one of the endogenous drives that impacts short and long-term health and well-being, it is important to consider how social isolation during the COVID-19 government-mandated quarantines affected sleep and sleep habits. A number of researchers have addressed this question during the last 2 years by examining (...) several concepts related to possible changes in sleep during the quarantines. To best understand these recent results, the current mini review provides a background on the pre-pandemic literature on the effects of social isolation and loneliness with a focus on sleep and then summarizes the recent literature on sleep and sleep habits. In general, sleep was negatively impacted for many people during the pandemics but not all. One group that seemed to benefit from the pandemic in terms of sleep patterns, were younger people who could more easily adapt their sleep times to match their internal chronobiology. Given the potential broad impact of sleep on health and well-being, better understanding how social isolation impacts sleep is an important consideration for individuals, work organizations, and governments. (shrink)

There are two main approaches to how statistical patterns are extracted from sequences: The transitional probability approach proposes that statistical learning occurs through the computation of probabilities between items in a sequence. The chunking approach, including models such as PARSER and TRACX, proposes that units are extracted as chunks. Importantly, the chunking approach suggests that the extraction of full units weakens the processing of subunits while the transitional probability approach suggests that both units and subunits should strengthen. Previous findings using (...) sequentially organized, auditory stimuli or spatially organized, visual stimuli support the chunking approach. However, one limitation of prior studies is that most assessed learning with the two-alternative forced-choice task. In contrast, this pre-registered experiment examined the two theoretical approaches in sequentially organized, visual stimuli using an online self-paced task—arguably providing a more sensitive index of learning as it occurs—and a secondary offline familiarity judgment task. During the self-paced task, abstract shapes were covertly organized into eight triplets (ABC) where one in every eight was altered (BCA) from the canonical structure in a way that disrupted the full unit while preserving a subunit (BC). Results from the offline familiarity judgment task revealed that the altered triplets were perceived as highly familiar, suggesting the learned representations were relatively flexible. More importantly, results from the online self-paced task demonstrated that processing for subunits, but not unit-initial stimuli, was impeded in the altered triplet. The pattern of results is in line with the chunking approach to statistical learning and, more specifically, the TRACX model. (shrink)

Psychopathy is a disorder characterized by severe and frequent moral violations in multiple domains of life. Numerous studies have shown psychopathy-related limbic brain abnormalities during moral processing; however, these studies only examined negatively valenced moral stimuli. Here, we aimed to replicate prior psychopathy research on negative moral judgments and to extend this work by examining psychopathy-related abnormalities in the processing of controversial moral stimuli and positive moral processing. Incarcerated adult males (N = 245) completed a functional magnetic resonance imaging protocol (...) on a mobile imaging system stationed at the prison. Psychopathy was assessed using the Hare Psychopathy Checklist–Revised (PCL-R). Participants were then shown words describing three types of moral stimuli: wrong (e.g., stealing), not wrong (e.g., charity), and controversial (e.g., euthanasia). Participants rated each stimulus as either wrong or not wrong. PCL-R total scores were correlated with not wrong behavioral responses to wrong moral stimuli, and were inversely related to hemodynamic activity in the anterior cingulate cortex in the contrast of wrong > not wrong. In the controversial > noncontroversial comparison, psychopathy was inversely associated with activity in the temporal parietal junction and dorsolateral prefrontal cortex. These results indicate that psychopathy-related abnormalities are observed during the processing of complex, negative, and positive moral stimuli. (shrink)

In humans over 15% of X‐linked genes have been shown to ‘escape’ from X‐chromosome inactivation (XCI): they continue to be expressed to some extent from the inactive X chromosome. Mono‐allelic expression is anticipated within a cell for genes subject to XCI, but random XCI usually results in expression of both alleles in a cell population. Using a study of allelic expression from cultured lymphoblasts and fibroblasts, many of which showed substantial skewing of XCI, we recently reported that the expression of (...) genes lies on a contiunuum between those that are subject to inactivation, and those that escape. We now review allelic expression studies from mouse, and discuss the variability in escape seen in both humans and mice in genic expression levels, between X chromosomes and between tissues. We also discuss current knowledge of the heterochromatic features, DNA elements and three‐dimensional topology of the inactive X that contribute to the balance of expression from the otherwise inactive X chromosome. (shrink)

The study of anarchism as a philosophical, political, and social movement has burgeoned both in the academy and in the global activist community in recent years. Taking advantage of this boom in anarchist scholarship, Nathan J. Jun and Shane Wahl have compiled twenty-six cutting-edge essays on this timely topic in New Perspectives on Anarchism.

Pericytes, like vascular smooth muscle cells, are perivascular cells closely associated with blood vessels throughout the body. Pericytes are necessary for vascular development and homeostasis, with particularly critical roles in the brain, where they are involved in regulating cerebral blood flow and establishing the blood-brain barrier. A role for pericytes during neurovascular disease pathogenesis is less clear—while some studies associate decreased pericyte coverage with select neurovascular diseases, others suggest increased pericyte infiltration in response to hypoxia or traumatic brain injury. Here, (...) we used an endothelial loss-of-function Recombination signal binding protein for immunoglobulin kappa J region (Rbpj)/Notch mediated mouse model of brain arteriovenous malformation (AVM) to investigate effects on pericytes during neurovascular disease pathogenesis. We tested the hypothesis that pericyte expansion, via morphological changes, and Platelet-derived growth factor B/Platelet-derived growth factor receptor β (Pdgf-B/Pdgfrβ)-dependent endothelial cell-pericyte communication are affected, during the pathogenesis of Rbpj mediated brain AVM in mice. Our data show that pericyte coverage of vascular endothelium expanded pathologically, to maintain coverage of vascular abnormalities in brain and retina, following endothelial deletion of Rbpj. In Rbpj-mutant brain, pericyte expansion was likely attributed to cytoplasmic process extension and not to increased pericyte proliferation. Despite expanding overall area of vessel coverage, pericytes from Rbpj-mutant brains showed decreased expression of Pdgfrβ, Neural (N)-cadherin, and cluster of differentiation (CD)146, as compared to controls, which likely affected Pdgf-B/Pdgfrβ-dependent communication and appositional associations between endothelial cells and pericytes in Rbpj-mutant brain microvessels. By contrast, and perhaps by compensatory mechanism, endothelial cells showed increased expression of N-cadherin. Our data identify cellular and molecular effects on brain pericytes, following endothelial deletion of Rbpj, and suggest pericytes as potential therapeutic targets for Rbpj/Notch related brain AVM. (shrink)

Investigations into the neurobiology of moral cognition are often done by examining clinical populations characterized by diminished moral emotions and a proclivity toward immoral behavior. Psychopathy is the most common disorder studied for this purpose. Although cocaine abuse is highly co-morbid with psychopathy and cocaine-dependent individuals exhibit many of the same abnormalities in socio-affective processing as psychopaths, this population has received relatively little attention in moral psychology. To address this issue, the authors used functional magnetic resonance imaging (fMRI) to record (...) hemodynamic activity in 306 incarcerated male adults, stratified into regular cocaine users (n = 87) and a matched sample of non-cocaine users (n = 87), while viewing pictures that did or did not depict immoral actions and determining whether each depicted scenario occurred indoors or outdoors. Consistent with expectations, cocaine users showed abnormal neural activity in several frontostriatial regions during implicit moral picture processing compared to their non-cocaine using peers. This included reduced moral/non-moral picture discrimination in the vACC, vmPFC, lOFC, and left vSTR. Additionally, psychopathy was negatively correlated with activity in an overlapping region of the ACC and right lateralized vSTR. These results suggest that regular cocaine abuse may lead to affective deficits which can impact relatively high-level processes like moral cognition. Moreover, they add to a growing body of research suggesting an important role for the mesocorticolimbic dopamine pathway in socio-affective processing. (shrink)

The Routledge Handbook of Philosophy of the City is an outstanding reference source to this exciting subject and the first collection of its kind. Comprising 40 chapters by a team of international contributors, the Handbook is divided into clear sections addressing the following central topics: -/- • Historical Philosophical Engagements with Cities -/- • Modern and Contemporary Philosophical Theories of the City -/- • Urban Aesthetics -/- • Urban Politics -/- • Citizenship -/- • Urban Environments and the Creation/Destruction of (...) Place. -/- The concluding section, Urban Engagements, contains interviews with philosophers discussing their engagement with students and the wider public on issues and initiatives including experiential learning, civic and community engagement, disability rights and access, environmental degradation, professional diversity, social justice, and globalization. -/- Essential reading for students and researchers in environmental philosophy, aesthetics, and political philosophy, The Routledge Handbook of Philosophy of the City is also a useful resource for those in related fields, such as geography, urban studies, sociology, and political science. (shrink)

Resumen Las enfermedades raras o poco frecuentes constituyen un tema muy complejo desde el punto de vista socio-sanitario y también desde el punto de vista comunicativo. Afectan a menos de 5 por 10.000 personas y suelen ser graves y crónicas. La mayor parte son de origen genético por lo que, con frecuencia, se manifiestan en la etapa infantil. Apenas un diez por ciento tiene tratamientos efectivos. Son pocos los estudios que han abordado el discurso sobre estas patologías. Las ER constituyen (...) aún un tópico que podríamos denominar ‘emergente’ para los profesionales de los medios de comunicación. En este artículo vamos a analizar la representación de las enfermedades raras y de sus principales protagonistas en un corpus de 436 piezas informativas correspondientes a enero de 2014. Desde las premisas del Análisis Crítico del Discurso, estudiaremos los aspectos más relevantes tanto desde el punto de vista macroestructural, como microestructural. (shrink)

Mounting evidence documents the extraordinary toll on human health resulting from the consumption of unhealthy food products and physical inactivity. In response to America's growing obesity problem, local policymakers have been looking for legal strategies that can be adopted in their communities to encourage healthful behaviors. In order to provide practical tools to policymakers, this article examines four possible venues for local policy change to improve the health of a community: the school environment the built environment () community facilities and (...) the point of sale environment. Finally, the article examines the use of taxes or fees as a means of paying for nutrition policy work as well as potentially reducing the consumption of unhealthy products. This article illustrates that local laws and policies can be a valuable tool in changing a community's environment in order to improve nutritional options and increase opportunities for physical activity. (shrink)

Mounting evidence documents the extraordinary toll on human health resulting from the consumption of unhealthy food products and physical inactivity. Diseases related to poor nutrition – such as diabetes, heart disease, stroke, and some cancers – are among the leading causes of disability and death in the United States. Poor diet and lack of exercise come second only to tobacco use in actual causes of preventable death in this country. It is estimated that 6% of all adult health care, 7% (...) of Medicare, and 11% of Medicaid expenditures are attributable to obesity. According to the Centers for Disease Control and Prevention, the direct medical cost associated with physical inactivity was nearly $76.6 billion in 2000.In response to America's growing obesity problem, local policymakers have been looking for legal strategies to adopt in their communities to encourage healthful behaviors. Taking the lead from the successful tobacco control movement, nutrition advocates are seeking strategies to “denormalize” unhealthy behaviors, rather than pursuing education-based approaches that encourage individuals to change their own personal behavior. (shrink)

Whole–exome sequencing (WES) has increased our ability to analyze large parts of the human genome, bringing with it a plethora of ethical, legal, and social implications. A topic dominating discussion of WES is identification of “secondary findings” (SFs), defined as the identification of risk in an asymptomatic individual unrelated to the indication for the test. SFs can have considerable psychosocial impact on patients and families, and patients with an SF may have concerns regarding genomic privacy and genetic discrimination. The Genetic (...) Information Nondiscrimination Act of 2008 (GINA) currently excludes protections for members of the military. This may cause concern in military members and families regarding genetic discrimination when considering genetic testing. In this report, we discuss a case involving a patient and family in which a secondary finding was discovered by WES. The family members have careers in the U.S. military, and a risk–predisposing condition could negatively affect employment. While beneficial medical management changes were made, the information placed exceptional stress on the family, who were forced to navigate career–sensitive “extra–medical” issues, to consider the impacts of uncovering risk–predisposition, and to manage the privacy of their genetic information. We highlight how information obtained from WES may collide with these issues and emphasize the importance of genetic counseling for anyone undergoing WES. (shrink)

Recent research suggests holding a structural, rather than interpersonal, understanding of racism is associated with greater impetus to address racial disparities. We believe greater acknowledgment of structural racism also functions to mitigate against empathic failures in response to structural injustices. Given South Africa’s situatedness as a country characterized by historical racialized oppression and continuing unjust legacies, it is appropriate to examine these ideas there. Across three studies, we tested the hypotheses that members of advantaged groups’ perspective taking and empathic concern (...) may be compromised in response to people challenging the unequal status quo, and that a priori perceptions about the impact of structural racism may mitigate or exacerbate such empathic failures. In Study 1, a national sample of White South Africans endorsed perceptions of interpersonal racism more readily than perceptions of structural racism, and expressed high levels of competitive victimhood for perceived anti-White structural racism. Studies 2 and 3 showed that White participants at a historically White university responded with impaired perspective taking and intergroup empathy bias in response to people challenging structural disparities. Finally, reduced recognition of continuing structural racism predicted greater intergroup empathy bias, which, in turn, was associated with reduced willingness to engage in intergroup discussions about past harm. We propose that greater acknowledgment of structural racism is necessary not only to surmount intergroup empathic failures, but also to transcend the socioeconomically unequal legacies of apartheid and beyond. (shrink)

This handbook presents a comprehensive introduction to the core areas of philosophy of education combined with an up-to-date selection of the central themes. It includes 95 newly commissioned articles that focus on and advance key arguments; each essay incorporates essential background material serving to clarify the history and logic of the relevant topic, examining the status quo of the discipline with respect to the topic, and discussing the possible futures of the field. The book provides a state-of-the-art overview of philosophy (...) of education, covering a range of topics: Voices from the present and the past deals with 36 major figures that philosophers of education rely on; Schools of thought addresses 14 stances including Eastern, Indigenous, and African philosophies of education as well as religiously inspired philosophies of education such as Jewish and Islamic; Revisiting enduring educational debates scrutinizes 25 issues heavily debated in the past and the present, for example care and justice, democracy, and the curriculum; New areas and developments addresses 17 emerging issues that have garnered considerable attention like neuroscience, videogames, and radicalization. The collection is relevant for lecturers teaching undergraduate and graduate courses in philosophy of education as well as for colleagues in teacher training. Moreover, it helps junior researchers in philosophy of education to situate the problems they are addressing within the wider field of philosophy of education and offers a valuable update for experienced scholars dealing with issues in the sub-discipline. Combined with different conceptions of the purpose of philosophy, it discusses various aspects, using diverse perspectives to do so. Contributing Editors: Section 1: Voices from the Present and the Past: Nuraan Davids Section 2: Schools of Thought: Christiane Thompson and Joris Vlieghe Section 3: Revisiting Enduring Debates: Ann Chinnery, Naomi Hodgson, and Viktor Johansson Section 4: New Areas and Developments: Kai Horsthemke, Dirk Willem Postma, and Claudia Ruitenberg. (shrink)

Numerous social, economic and academic pressures can have a negative impact on representations of biomedical research. We review several of the forces playing an increasingly pernicious role in how health and science information is interpreted, shared and used, drawing discussions towards the role of narrative. In turn, we explore how aspects of narrative are used in different social contexts and communication environments, and present creative responses that may help counter the negative trends. As traditional methods of communication have in many (...) ways failed the public, changes in approach are required, including the creative use of narratives. (shrink)

When the COVID-19 surge hit New York City hospitals, the Division of Medical Ethics at Weill Cornell Medical College, and our affiliated ethics consultation services, faced waves of ethical issues sweeping forward with intensity and urgency. In this article, we describe our experience over an eight-week period (16 March through 10 May 2020), and describe three types of services: clinical ethics consultation (CEC); service practice communications/interventions (SPCI); and organizational ethics advisement (OEA). We tell this narrative through the prism of time, (...) describing the evolution of ethical issues and trends as the pandemic unfolded. We delineate three phases: anticipation and preparation, crisis management, and reflection and adjustment. The first phase focused predominantly on ways to address impending resource shortages and to plan for remote ethics consultation, and CECs focused on code status discussions with surrogates. The second phase was characterized by the dramatic convergence of a rapid increase in the number of critically ill patients, a growing scarcity of resources, and the reassignment/ redeployment of staff outside their specialty areas. The third phase was characterized by the recognition that while the worst of the crisis was waning, its medium- and long-term consequences continued to pose immense challenges. We note that there were times during the crisis that serving in the role of clinical ethics consultant created a sense of dis-ease as novel as the coronavirus itself. In retrospect we learned that our activities far exceeded the familiar terrain of clinical ethics consultation and extended into other spheres of organizational life in novel ways that were unanticipated before this pandemic. To that end, we defined and categorized a middle level of ethics consultation, which we have termed service practice communication intervention (SPCI). This is an underappreciated dimension of the work that ethics consult services are capable of in times of crisis. We believe that the pandemic has revealed the many enduring ways that ethics consultation services can more robustly contribute to the ethical life of their institutions moving forward. (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)

Can all goods or bads be broken down into smaller and smaller pieces? Can all goods or bads be added together with some other good or bad to get a larger amount? Further, how does moral significance track the disaggregation and the aggregation of moral goods and bads? In Part 1, I examine the limits placed on aggregation by moderate deontological moral theories. This paper focuses in particular on the work of Judith Thomson and T.M. Scanlon as well as on (...) some of my own past work on the question of aggregation in the context of overriding rights. In Part 2, I examine consequentialist criticism that harms and benefits can be broken down into smaller pieces than the deontological theory allows and the argument that the moderate deontological view is too permissive since it allows aggregation of benefits within a single person's life. In Part 3 I suggest how a moderate deontological moral theory might respond to the criticisms. I cast my answer in terms of the existence of lumpy goods and bads. I argue that consequentialist critics of deontology are wrong to insist that all goods and bads can be disaggregated and aggregated at will. Instead, I offer the suggestion that most, or many, goods and bads come in morally significant lumps. That said, it will not always be obvious what those lumps are. Determining the texture of moral value is a substantive project in normative ethics. All I have hoped to do in this paper is suggest that two standard positions on how to group moral value are mistaken and give hope that we need not adopt one of the two. Part 4 of the paper responds to an objection and sets the stage for further work in value theory. (shrink)

Despite its effectiveness, limited research has examined the provision of telemental health and how practices may vary according to treatment paradigm. We surveyed 276 community mental health providers registered with a commercial telemedicine platform. Most providers reported primarily offering TMH services to adults with anxiety, depression, and trauma-and stressor-related disorders in individual therapy formats. Approximately 82% of TMH providers reported endorsing the use of Cognitive Behavioral Therapy in their remote practice. The most commonly used in-session and between-session exercises included coping (...) and emotion regulation, problem solving, mindfulness, interpersonal skills, relaxation, and modifying and addressing core beliefs. CBT TMH providers had a higher odds of using in-session and homework exercises and assigning them through postal mail, email or fax methods, as compared to non-CBT TMH providers. TMH providers, regardless of treatment paradigm, felt that assigning homework was neither easy nor difficult and they believed their patients were somewhat-to-moderately compliant to their assigned exercises. CBT TMH providers also collected clinical information from their patients more often than non-CBT TMH providers. They reported being less satisfied with their method, which was identified most often as paper-based surveys and forms. Overall, TMH providers employ evidence-based treatments to their patients remotely, with CBT TMH providers most likely to do so. Findings highlight the need for innovative solutions to improve how TMH providers that endorse following the CBT treatment paradigm remotely assign homework and collect clinical data to increase their satisfaction via telemedicine. (shrink)

IntroductionCognitive impairment is a highly prevalent non-motor feature of Parkinson’s disease. A better understanding of the underlying pathophysiology may help in identifying therapeutic targets to prevent or treat dementia. This study sought to identify metabolic alterations in the prefrontal cortex, a key region for cognitive functioning that has been implicated in cognitive dysfunction in PD.MethodsProton Magnetic Resonance Spectroscopy was used to investigate metabolic changes in the PFC of a cohort of cognitively normal individuals without PD, as well as PD participants (...) with either normal cognition, mild cognitive impairment, or dementia. Ratios to Creatine resonance were obtained for glutamate, glutamine and glutamate combined, N-acetylaspartate, myoinositol, and total choline, and correlated with cognitive scores across multiple domains administered to the PD participants only.ResultsWhen individuals retain cognitive capabilities, the presence of Parkinson’s disease does not create metabolic disturbances in the PFC. However, when cognitive symptoms are present, PFC Glu/Cre ratios decrease with significant differences between the PD-NC and PPD groups. In addition, Glu/Cre ratios and memory scores were marginally associated, but not after Bonferroni correction.ConclusionThese preliminary findings indicate that fluctuations in prefrontal glutamate may constitute a biomarker for the progression of cognitive impairments in PD. We caution for larger MRS investigations of carefully defined PD groups. (shrink)

In Miniland USA, the nation itself takes on many of the characteristics of the fan developed theme (FDT): vignettes of LEGO bricks, thematically unified as "American", based on representations of locations throughout the United States. Frequently referred to as the "heart" of the LEGOLAND theme parks, Miniland is a section made up of scaled‐down versions of national landmarks and icons, artfully arranged around winding paths. Contemporary domestic tourism envisions the United States as several distinct geographic zones, differentiated by metropolitan centers (...) and regional characteristics (primarily climate, food, and dialect). Tourist guides and maps reinforce this configuration, highlighting roughly the same delineation of regions: The Northeast,Mid‐Atlantic, Southeast, Southwest, Midwest, and Pacific Northwest. Echoing this conception of the national itinerary, LEGOLAND California's Miniland USA contains miniature versions of six different American locations: New York City, Washington DC, "New England", New Orleans, Las Vegas, and California. (shrink)