Spanning our differences: moral psychology,physician beliefs,and the practice of medicine

Moral pluralism is the norm in contemporary society. Even the best philosophical arguments rarely persuade moral opponents who differ at a foundational level. This has been vividly illustrated in contemporary debates in bioethics surrounding contentious issues such as abortion and euthanasia. It is readily apparent that bioethics discourse lacks an empirical explanation for the broad differences about various topics in bioethics and health policy. In recent years, social and cognitive psychology has generated novel approaches for defining basic differences in moral intuitions generally. We propose that if empirical research using social intuitionist theory explains why people disagree with one another over moral issues, then the results of such research might help people debate their moral differences in a more constructive and civil manner. We illustrate the utility of social intuitionism with data from a national physician survey.     

Threatening scenes but not threatening faces shorten time-to-contact estimates

We previously reported that time-to-contact (TTC) judgments of threatening scene pictures (e.g., frontal attacks) resulted in shortened estimations and were mediated by cognitive processes, and that judgments of threatening (e.g., angry) face pictures resulted in a smaller effect and did not seem cognitively mediated. In the present study, the effects of threatening scenes and faces were compared in two different tasks. An effect of threatening scene pictures occurred in a prediction-motion task, which putatively requires cognitive motion extrapolation, but not in a relative TTC judgment task, which was designed to be less reliant on cognitive processes. An effect of threatening face pictures did not occur in either task. We propose that an object’s explicit potential of threat per se, and not only emotional valence, underlies the effect of threatening scenes on TTC judgments and that such an effect occurs only when the task allows sufficient cognitive processing. Results are consistent with distinctions between predator and social fear systems and different underlying physiological mechanisms. Not all threatening information elicits the same responses, and whether an effect occurs at all may depend on the task and the degree to which the task involves cognitive processes.     

Extensive occupational finger use delays age effects in tactileperception—an ERP study

Tactile expertise, resulting from extensive use of hands, has previously been shown to improve tactile perception in blind people and musicians and to be associated with changes in the central processing of tactile information. This study investigated whether expertise, due to precise and deliberate use of the fingers at work, relates to improved tactile perception and whether this expertise interacts with age. A tactile pattern and a frequency discrimination task were conducted while ERPs were measured in experts and nonexperts of two age groups within middle adulthood. Independently of age, accuracy was better in experts than in nonexperts in both tasks. Somatosensory N70 amplitudes were larger with increasing age and for experts than for nonexperts. P100 amplitudes were smaller in experts than in nonexperts in the frequency discrimination task. In the pattern discrimination task, P300 difference wave amplitude was reduced in experts and late middle-aged adults. In the frequency discrimination task, P300 was more equally distributed in late middle-aged adults. We conclude that extensive, dexterous manual work leads to acquisition of tactile expertise and that this expertise might delay, but not counteract, age effects on tactile perception. Comparable neurophysiological changes induced by age and expertise presumably have different underlying mechanisms. Enlarged somatosensory N70 amplitudes might result from reduced inhibition in older adults but from enhanced, specific excitability of the somatosensory cortex in experts. Regarding P300, smaller amplitudes might indicate fewer available resources in older adults and, by contrast, a reduced need to engage as much cognitive effort to the task in experts.     

Medical Trainees’ Readiness for the Promotion of Sexual Health in Tunisia: A Cross Sectional Study

In the Arab and Muslim countries, there are several taboos of sexuality. To overcome the latter, and to distinguish between cultural and scientific data, sexual education is a key measure, especially during medical studies. The purpose of this study was to assess the knowledge of the Tunisian medical trainees and to identify their sources of information concerning sexuality. We conducted a survey among medical trainees of the faculty of medicine of Sfax, in Tunisia. An anonymous questionnaire was distributed to 171 and completed by 157 trainees (91.8%). The sources of knowledge about sexuality were: friends (81.5%; N = 128), internet (77.1%; N = 121), television and movies (68.2%; N = 107), courses at the faculty (40.1%; N = 63) and parents (22.9%; N = 36). The score of correct answers was higher than or equal to 75% for 28 trainees (17.8%). It was on average 63.3%. It was correlated with male gender (p = 0.006), being a second-year trainee (p = 0.017) and television and movies as a source of knowledge about sexuality (p = 0.008). Masturbation was considered pathological by 17.2% of participants (N = 27). A 5-min period of intercourse was deemed sufficient to have a female orgasm by 44 trainees (28%). Andropause and menopause are inconsistent with a satisfying sexuality according to 44.6% (N = 70) and 56.1% (N = 88) of the participants respectively.     

Getting credit for OCBs: potential costs of being a good actor vs. a good soldier

Employing a sample of 197 employee-supervisor dyads, we explore whether employees’ attitudes and underlying motivation for engaging in organizational citizenship behaviours (OCBs) differentially relate to supervisors’ assessments of their individual performance and reward recommendations. We theorized that employees who perform OCBs with self-serving motives would be low on affective commitment and high on equity sensitivity, and that such individuals would receive lower performance ratings and fewer reward recommendations than those who are high on affective commitment, low on equity sensitivity, and more selflessly motivated. Our results suggest that employees with high affective commitment, low equity sensitivity, and high selfless motives were more likely to receive positive supervisor performance ratings and high reward recommendations. We also found that affective commitment moderated the mediating path of prosocial values (a selfless motive) on the relationship between OCBs and reward recommendations. Practical implications and future research directions are discussed.     

Scientists Still Behaving Badly? A Survey Within Industry and Universities

Little is known about research misconduct within industry and how it compares to universities, even though a lot of biomedical research is performed by–or in collaboration with–commercial entities. Therefore, we sent an e-mail invitation to participate in an anonymous computer-based survey to all university researchers having received a biomedical research grant or scholarship from one of the two national academic research funders of Belgium between 2010 and 2014, and to researchers working in large biomedical companies or spin-offs in Belgium. The validated survey included questions about various types of research misconduct committed by respondents themselves and observed among their colleagues in the last three years. Prevalences of misconduct were compared between university and industry respondents using binary logistic regression models, with adjustments for relevant personal characteristics, and with significance being accepted for p < 0.01. The survey was sent to 1766 people within universities and an estimated 255 people from industry. Response rates were 43 (767/1766) and 48% (123/255), and usable information was available for 617 and 100 respondents, respectively. In general, research misconduct was less likely to be reported by industry respondents compared to university respondents. Significant differences were apparent for one admitted action (gift authorship) and three observed actions (plagiarism, gift authorship, and circumventing animal-subjects research requirements), always with lower prevalences for industry compared to universities, except for plagiarism. This survey, based on anonymous self-report, shows that research misconduct occurs to a substantial degree among biomedical researchers from both industry and universities.     

An Evidence-Based,Community-Engaged Approach to Develop an Interactive Deliberation Tool for Pediatric Neuromuscular Trials

Duchenne/Becker muscular dystrophy (DBMD) and spinal muscular atrophy (SMA) are rare neuromuscular disorders that present challenges to therapeutic and clinical trial decision making. We developed an interactive, evidence-based online tool designed to encourage thoughtful deliberation of the pros and cons of trial participation and to inform meaningful discussions with healthcare providers. Prior research demonstrates the importance of tool availability at the time each family is considering trial participation, which may be prior to the informed consent process. The tool is intended to be easily modified to other pediatric disease communities. Tool development was informed by prior qualitative research, literature reviews, and stakeholder input. Specific items were derived based on an online exploratory questionnaire of parents whose children participated in a trial for DBMD or SMA to understand motivations for participation. Parent participants in the exploratory survey reported strong impact of altruistic and individual benefit motivations and placed much greater emphasis on anticipated trial benefits than on harms when making participation decisions. We used this data to develop the evidence-based deliberation tool using a community-engaged approach. We initially targeted the tool for DBMD while using SMA survey data to evaluate ease of transition to that population. We conducted two iterative sets of activities to inform development and refinement of the tool: (1) community engagement of key stakeholders and (2) user experience testing. These activities suggest that the tool may increase deliberation and the weighing of benefits and harms. Ongoing evaluation will determine the acceptability and efficacy of this online intervention.     

Very Young Child Well-being in Military Families: A Snapshot

Since the September 11th attacks on the U.S., more than 2 million children have experienced parental deployment during their early years, with potentially lasting impact. When a parent is deployed, a number of factors may affect the well-being of the service member and his/her family. One parental factor—posttraumatic stress disorder or distress—might be particularly powerful in its effect on young children and the family system. We analyzed baseline data from an intervention development project which focused on supporting military families with very young children during post-deployment. The purpose of this research is to understand the relationships between parental mental health status, parenting stress, couple functioning, and young child well-being. The effects of mental health status of home-front and service member parents and the role of couple functioning on parent–child interactions and behavioral problems of young children were examined in a sample of military families during the post-deployment period. Findings suggest that service member posttraumatic stress symptoms are associated with higher parental report of child behavior problems. Higher quality of the couple relationship appears to lessen the impact of parental posttraumatic stress but is not related to parent perceptions of child behavior concerns. Implications for future research with military families are discussed.