Doctor can I buy a new kidney? I've heard it isn't forbidden: what is the role of the nephrologist when dealing with a patient who wants to buy a kidney?

Organ trafficking is officially banned in several countries and by the main Nephrology Societies. However, this practice is widespread and is allowed or tolerated in many countries, hence, in the absence of a universal law, the caregiver may be asked for advice, placing him/her in a difficult balance between legal aspects, moral principles and ethical judgments.In spite of the Istanbul declaration, which is a widely shared position statement against organ trafficking, the controversy on mercenary organ donation is still open and some experts argue against taking a negative stance. In the absence of clear evidence showing the clinical disadvantages of mercenary transplantation compared to chronic dialysis, self-determination of the patient (and, with several caveats, of the donor) may conflict with other ethical principles, first of all non-maleficence. The present paper was drawn up with the participation of the students, as part of the ethics course at our medical school. It discusses the situation in which the physician acts as a counselor for the patient in the way of a sort of “reverse” informed consent, in which the patient asks advice regarding a complex personal decision, and includes a peculiar application of the four principles (beneficence, non-maleficence, justice and autonomy) to the donor and recipient parties.     

The Role of Identity Integration in Hedonic Adaptation to a Beneficial Life Change: The Example of “Coming Out” for Lesbians and Gay Men

After apparently beneficial life changes, people are expected to experience elevated well-being. However, research suggests that some individuals adapt quickly to change, so their well-being increases little in the long-term. We propose this phenomenon is explained by the integration of the changes into identity, in interaction with perceived valence of the changes. We hypothesized that higher integration would be associated with smaller increases in well-being for changes perceived as positive. For changes perceived as negative, higher integration would be associated with larger increases in well-being. Lesbians and gay men (N = 80) completed a questionnaire on well-being, perceived valence of coming out and its integration into identity. Moderated regressions supported the hypotheses, revealing the importance of considering identity integration and perceived valence in research on adaptation to changes. The results question the merits of interventions promoting identity integration.     

Dyadic Cross-Sectional Associations Between Negative Mood,Marital Idealization,and Relationship Quality

This study aimed to evaluate (a) dyadic associations between relationship quality (RQ) and both depressive and anxious mood (DM and AM), (b) reciprocity hypotheses of negative mood within dyadic interactions, and (c) mediational role of marital idealization between negative mood and relationship quality. Actor-partner interdependence models (APIMs) were performed using data from a sample of 198 dyads. Our results showed that (a) these two facets of negative mood did not have the same weight on RQ and that they had a gender-specific effects pattern, and (b) there was no support for the mood transmission hypothesis. Men's DM displayed direct and indirect (via marital idealization) actor as well as partner effects on RQ, whereas women's DM displayed only a direct actor effect on RQ. There were no significant direct actor effects of AM on RQ, meaning that this link is fully mediated by marital idealization. However, only women's AM showed such indirect effects on RQ.     

Trajectories of Oppositional Defiant Disorder Irritability Symptoms in Preschool Children

This study traces the developmental course of irritability symptoms in oppositional defiant disorder (ODD) from ages 3–5 and examines the psychopathological outcomes of the different trajectories at age 6. Method. A sample of 622 3-year-old preschoolers (311 were boys), followed up until age 6, was assessed yearly with a semi-structured diagnostic interview with parents and at age 6 with questionnaires answered by parents, teachers and children. Results. Growth-Mixture-Modeling yielded five trajectories of irritability levels for the whole sample (high-persistent 3.5 %, decreasing 3.8 %, increasing 2.6 %, low-persistent 44.1 % and null 46.0 %). Among the children who presented with ODD during preschool age, three trajectories of irritability symptoms resulted (high-persistent 31.9 %, decreasing 34.9 % and increasing 33.2 %). Null, low-persistent and decreasing irritability courses in the sample as a whole gave very similar discriminative capacity for children’s psychopathological state at age 6, while the increasing and high-persistent categories involved poorer clinical outcomes than the null course. For ODD children, the high-persistent and increasing trajectories of irritability predicted disruptive behavior disorders, comorbidity, high level of functional impairment, internalizing and externalizing problems and low anger control at age 6. Conclusions. Irritability identifies a subset of ODD children at high risk of poorer longitudinal psychopathological and functional outcomes. It might be clinically relevant to identify this subset of ODD children with a high number of irritability symptoms throughout development with a view to preventing comorbid and future adverse longitudinal outcomes.     

The emotional body and time perception

We examined the effects of emotional bodily expressions on the perception of time. Participants were shown bodily expressions of fear, happiness and sadness in a temporal bisection task featuring different stimulus duration ranges. Stimulus durations were judged to be longer for bodily expressions of fear than for those of sadness, whereas no significant difference was observed between sad and happy postures. In addition, the magnitude of the lengthening effect of fearful versus sad postures increased with duration range. These results suggest that the perception of fearful bodily expressions increases the level of arousal which, in turn, speeds up the internal clock system underlying the representation of time. The effect of bodily expressions on time perception is thus consistent with findings for other highly arousing emotional stimuli, such as emotional facial expressions.