A proposed ethical framework for vaccine mandates: competing values and the case of HPV

Debates over vaccine mandates raise intense emotions, as reflected in the current controversy over whether to mandate the vaccine against human papilloma virus (HPV), the virus that can cause cervical cancer. Public health ethics so far has failed to facilitate meaningful dialogue between the opposing sides. When stripped of its emotional charge, the debate can be framed as a contest between competing ethical values. This framework can be conceptualized graphically as a conflict between autonomy on the one hand, which militates against government intrusion, and beneficence, utilitarianism, justice, and nonmaleficence on the other, which may lend support to intervention. When applied to the HPV vaccine, this framework would support a mandate based on utilitarianism, if certain conditions are met and if herd immunity is a realistic objective.     

Immediate memory consequences of the effect of emotion on attention to pictures

Emotionally arousing stimuli are at once both highly attention grabbing and memorable. We examined whether emotional enhancement of memory (EEM) reflects an indirect effect of emotion on memory, mediated by enhanced attention to emotional items during encoding. We tested a critical prediction of the mediation hypothesis-that regions conjointly activated by emotion and attention would correlate with subsequent EEM. Participants were scanned with fMRI while they watched emotional or neutral pictures under instructions to attend to them a lot or a little, and were then given an immediate recognition test. A region in the left fusiform gyrus was activated by emotion, voluntary attention, and subsequent EEM. A functional network, different for each attention condition, connected this region and the amygdala, which was associated with emotion and EEM, but not with voluntary attention. These findings support an indirect cortical mediation account of immediate EEM that may complement a direct modulation model.     

Precise instructions determine participants’ memory search strategy in judgments of relative order in short lists

Memory often requires knowledge of the order of events. Previous findings about immediate judgments of relative order in short, subspan lists are variable regarding whether participants’ strategy is to search memory in the forward direction, starting from the first list item and progressing toward the end item, or in the backward direction, starting from the end item and progressing toward the start. We asked whether wording of the instructions influences participants’ search direction. Participants studied sequences of three to six consonants, and for an immediate, two-item probe of each list, judged which probe was presented earlier (“earlier” instruction) or later (“later” instruction) on the list. Forward and backward searches were supported for “earlier” and “later” instructions, respectively. Our findings suggest that participants have more than one effective strategy for order judgments in short lists, and that subtle instructional differences can bias memory search in either the forward or backward direction.     

Working Memory and On-Line Sentence Comprehension in Patients with Alzheimer's Disease

We examined the ability of patients with dementia of the Alzheimer's type (DAT) and normal controls to perform a sentence acceptability judgment task that required determining the referent for a reflexive pronoun. Performance on three different sentence types that differed in terms of syntactic complexity was assessed. Subjects performed the task alone and under two different dual-task conditions which required continuous, externally paced responses. DAT patients were more affected than controls by the dual-task conditions, but were not disproportionately impaired on the more complex sentence types. The failure of DAT patients to he disproportionately affected on the most complex sentence types in the dual-task conditions provides evidence for the separation of the processing resources that are used in sentence comprehension from those involved in other tasks.     

Comprehension of gerundive constructions by Broca's aphasics

Eleven diagnosed Broca's aphasics were tested for comprehension of sentences containing gerundive constructions. Results showed that, as a group, these patients were sensitive to grammatical distinctions signaled by “function” words, contrary to the predictions of some current theories about the specific deficits exhibited in this syndrome. Further analysis showed that the patients fell into two subgroups, one which exhibited sensitivity to the distinctions in normal grammar, and another which exhibited no sensitivity to such distinctions. This suggests that the syndrome may have different manifestations in different populations—patient age is suggested as a possible means for distinguishing the two groups. Suggestions for further research into the nature of the comprehension deficits exhibited by Broca's aphasics are made.