Prescient human fetuses thrive

Fetal detection of adversity is a conserved trait that allows many species to adapt their early developmental trajectories to ensure survival. According to the fetal-programming model, exposure to stressful or hostile conditions in utero is associated with compromised development and a lifelong risk of adverse health outcomes. In a longitudinal study, we examined the consequences of prenatal and postnatal exposure to adversity for infant development. We found increased motor and mental development during the 1st year of life among infants whose mothers experienced congruent levels of depressive symptoms during and after pregnancy, even when the levels of symptoms were relatively high and the prenatal and postnatal environments were unfavorable. Congruence between prenatal and postnatal environments prepares the fetus for postnatal life and confers an adaptive advantage for critical survival functions during early development.     

When bonuses backfire: an inaction inertia analysis of procrastination induced by a missed opportunity

An inaction inertia analysis of procrastination was used to generate the prediction that using bonuses to encourage early task completion will have two opposing effects, encouraging early task completion by some but also inducing procrastination for those who miss the bonus. Study 1 showed that the addition of bonuses for early completion produced both of these effects and also led to overall task completion rates that were either equal to (large bonus) or actually less than (medium and small bonuses) those obtained by simply establishing a completion deadline with no bonus. In Study 2, a lottery methodology was used to manipulate the size of a missed bonus for all participants. Even under these conditions of reduced personal responsibility the larger missed bonus led to increased procrastination as predicted by the inaction inertia analysis. Possible mediating processes based on anticipated regret and perceived fairness were discussed. Copyright © 2007 John Wiley & Sons, Ltd.     

A model of the precaution adoption process: evidence from home radon testing.

We present the precaution adoption process model--a stage theory consisting of seven distinct states between ignorance and completed preventive action. The stages are "unaware of the issue," "aware of the issue but not personally engaged," "engaged and deciding what to do," "planning to act but not yet having acted," "having decided not to act," "acting," and "maintenance." The theory asserts that these stages represent qualitatively different patterns of behavior, beliefs, and experience and that the factors that produce transitions between stages vary depending on the specific transition being considered. Data from seven studies of home radon testing are examined to test some of the claims made by this model. Stage theories of protective behavior are contrasted with theories that see precaution adoption in terms of movement along a single continuum of action likelihood.     

Determinants of Self-Protective Behavior: Home Radon Testing

This field experiment explored the use of informational brochures to encourage home radon testing. Homeowners ( N = 271) received a radon brochure, a questionnaire, and a form for ordering a $20 radon test kit. The brochures differed in their presentations of the magnitude of the threat (varying risk likelihood and severity) and the difficulty of reducing radon levels. Some also included a detailed list of home radon risk factors. Combinations of these three variables yielded a 2 × 2 × 2 factorial design. Although 19.2% of the sample ordered tests, the percentage was constant across brochures. Data from the questionnaire showed that self-reported risk likelihood, risk seriousness, and concern were strongly correlated with intentions to test and with actual test orders. Calculations revealed that although the threat manipulation had a highly significant effect on these risk perceptions, the effect was too small to produce different rates of test orders. Confirming previous radon studies, perceived mitigation difficulty proved unrelated to interest in radon testing.     

Sex moderates associations between prenatal glucocorticoid exposure and human fetal neurological development

Maternal cortisol levels (at 15, 19, 25, 31 and 37 weeks’ gestation) and fetal movement response to vibroacoustic stimulation (VAS; at 25, 31 and 37 weeks) were assessed in 190 mother‐fetus pairs. Fetuses showed a response to the VAS at 25 weeks and there was evidence of increasing maturation in the response at 31 and 37 weeks. Early elevations in cortisol predicted a failure to respond to the VAS at 25 weeks and later elevations in cortisol were associated with a larger response among fetuses when assessed near term. The associations between cortisol and VAS emerged earlier and were more apparent among female fetuses than among the males. The findings provide support for the role of prenatal glucocorticoids in shaping human fetal CNS development.     

Shared decision-making and patient autonomy

In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to five different aspects of autonomy: (1) self-realisation; (2) preference satisfaction; (3) self-direction; (4) binary autonomy of the person; (5) gradual autonomy of the person. It is argued that both individually and jointly these aspects will support the models called shared rational deliberative patient choice and joint decision as the preferred versions from an autonomy perspective. Acknowledging that both of these models may fail, the professionally driven best interest compromise model is held out as a satisfactory second-best choice.     

Sleep arrangements and night waking at 6 and 12 months in relation to infants' stress‐induced cortisol responses

The objective of this short‐term longitudinal study was to examine the concurrent and prospective associations of infants' sleep arrangements and night waking with cortisol responses to an inoculation at 6 and 12 months, controlling for several key covariates. To our knowledge, this was the first study to concurrently and prospectively link proximity in sleep arrangements and night waking to physiological stress reactivity. A sample of 92 mother–infant dyads participated in the study when the infants were 6 and 12 months of age, although sample sizes were reduced for some analyses. Both proximal cosleeping arrangements and more frequent night wakings' were associated concurrently with an increased cortisol response to inoculations at both ages. Night waking at 6 months also was associated with a slightly increased cortisol response to inoculation at 12 months. Results aimed at exploring the direction of influence suggested that cosleeping and night waking may influence infant stress physiology rather than the reverse. Adaptive and maladaptive implications of infants' nocturnal experiences and greater stress‐induced cortisol responses are discussed. Copyright © 2009 John Wiley & Sons, Ltd.