The role of philosophy and ethics at the edges of medicine

Background

The purpose of this study is to make a philosophical argument against the phenomenological critique of standardization in clinical ethics. We used the context of clinical ethics in Saudi Arabia to demonstrate the importance of credentialing clinical ethicists.

Methods

Philosophical methods of argumentation and conceptual analysis were used.

Results

We found the phenomenological critique of standardization to be flawed because it relies on a series of false dichotomies.

Conclusions

We concluded that the phenomenological framing of the credentialing debate relies upon two extreme views to be navigated between, not chosen among, in the credentialing of clinical ethicists.

     

From Unemployment to Employment and Back: Professional Trajectories and Well-Being

Applied Research in Quality of Life - So far, only few studies have considered different aspects of well-being in studying losing or gaining employment. We examined life satisfaction, mental...     

Continuity between waking activities and dream activities

Empirical studies largely support the continuity hypothesis of dreaming. Despite of previous research efforts, the exact formulation of the continuity hypothesis remains vague. The present paper focuses on two aspects: (1) the differential incorporation rate of different waking-life activities and (2) the magnitude of which interindividual differences in waking-life activities are reflected in corresponding differences in dream content. Using a correlational design, a positive, non-zero correlation coefficient will support the continuity hypothesis. Although many researchers stress the importance of emotional involvement on the incorporation rate of waking-life experiences into dreams, formulated the hypothesis that highly focused cognitive processes such as reading, writing, etc. are rarely found in dreams due to the cholinergic activation of the brain during dreaming. The present findings based on dream diaries and the exact measurement of waking activities replicated two recent questionnaire studies. These findings indicate that it will be necessary to specify the continuity hypothesis more fully and include factors (e.g., type of waking-life experience, emotional involvement) which modulate the incorporation rate of waking-life experiences into dreams. Whether the cholinergic state of the brain during REM sleep or other alterations of brain physiology (e.g., down-regulation of the dorsolateral prefrontal cortex) are the underlying factors of the rare occurrence of highly focused cognitive processes in dreaming remains an open question. Although continuity between waking life and dreaming has been demonstrated, i.e., interindividual differences in the amount of time spent with specific waking-life activities are reflected in dream content, methodological issues (averaging over a two-week period, small number of dreams) have limited the capacity for detecting substantial relationships in all areas. Nevertheless, it might be concluded that the continuity hypothesis in its present general form is not valid and should be elaborated and tested in a more specific way.     

Efficacy of Attention Bias Modification Using Threat and Appetitive Stimuli: A Meta-Analytic Review

Attention bias modification (ABM) protocols aim to modify attentional biases underlying many forms of pathology. Our objective was to conduct an effect size analysis of ABM across a wide range of samples and psychological problems. We conducted a literature search using PubMed, PsycInfo, and author searches to identify randomized studies that examined the effects of ABM on attention and subjective experiences. We identified 37 studies (41 experiments) totaling 2,135 participants who were randomized to training toward neutral, positive, threat, or appetitive stimuli or to a control condition. The effect size estimate for changes in attentional bias was large for the neutral versus threat comparisons (g = 1.06), neutral versus appetitive (g = 1.41), and neutral versus control comparisons (g = 0.80), and small for positive versus control (g = 0.24). The effects of ABM on attention bias were moderated by stimulus type (words vs. pictures) and sample characteristics (healthy vs. high symptomatology). Effect sizes of ABM on subjective experiences ranged from 0.03 to 0.60 for postchallenge outcomes, –0.31 to 0.51 for posttreatment, and were moderated by number of training sessions, stimulus type, and stimulus orientation (top/bottom vs. left/right). Fail-safe N calculations suggested that the effect size estimates were robust for the training effects on attentional biases, but not for the effect on subjective experiences. ABM studies using threat stimuli produced significant effects on attention bias across comparison conditions, whereas appetitive stimuli produced changes in attention only when comparing appetitive versus neutral conditions. ABM has a moderate and robust effect on attention bias when using threat stimuli. Further studies are needed to determine whether these effects are also robust when using appetitive stimuli and for affecting subjective experiences.     

Emotional valence and physical space: limits of interaction

According to the body-specificity hypothesis, people associate positive things with the side of space that corresponds to their dominant hand and negative things with the side corresponding to their nondominant hand. Our aim was to find out whether this association holds also true for a response time study using linguistic stimuli, and whether such an association is activated automatically. Four experiments explored this association using positive and negative words. In Exp. 1, right-handers made a lexical judgment by pressing a left or right key. Attention was not explicitly drawn to the valence of the stimuli. No valence-by-side interaction emerged. In Exp. 2 and 3, right-handers and left-handers made a valence judgment by pressing a left or a right key. A valence-by-side interaction emerged: For positive words, responses were faster when participants responded with their dominant hand, whereas for negative words, responses were faster for the nondominant hand. Exp. 4 required a valence judgment without stating an explicit mapping of valence and side. No valence-by-side interaction emerged. The experiments provide evidence for an association between response side and valence, which, however, does not seem to be activated automatically but rather requires a task with an explicit response mapping to occur.     

Nonverbal signals speak up: Association between perceptual nonverbal dominance and emotional intelligence

Emotional communication uses verbal and nonverbal means. In case of conflicting signals, nonverbal information is assumed to have a stronger impact. It is unclear, however, whether perceptual nonverbal dominance varies between individuals and whether it is linked to emotional intelligence. Using audiovisual stimulus material comprising verbal and nonverbal emotional cues that were varied independently, perceptual nonverbal dominance profiles and their relations to emotional intelligence were examined. Nonverbal dominance was found in every participant, ranging from 55 to 100%. Moreover, emotional intelligence, particularly the ability to understand emotions, correlated positively with nonverbal dominance. Furthermore, higher overall emotional intelligence as well as a higher ability to understand emotions were linked to smaller reaction time differences between emotionally incongruent and congruent stimuli. The association between perceptual nonverbal dominance and emotional intelligence, and more specifically the ability to understand emotions, might reflect an adaptive process driven by the experience of higher authenticity in nonverbal cues.     

Contingency learning and stereotype formation: Illusory and spurious correlations revisited

The ability of implicit measures to predict behaviour varies greatly across studies, emphasising the need for accounts of this variability. In order to organise and review the literature on moderators that influence individuals' information processing, we suggest a classification system of moderators with two dimensions. One dimension distinguishes moderators according to their influence on the opportunity to control, the motivation to control, or the reliance on either automatic or controlled processes without changes in opportunity or motivation. The second dimension classifies moderators according to whether they pertain to a disposition of the acting person, the situation in which the behaviour occurs, or the behaviour itself. Increased predictive validity of implicit measures is associated with conditions that foster the impact of automatic processes on behaviour determination. In the discussion we derive several additional moderators from the classification system, delineate emerging research questions, and discuss implications of the reviewed studies for research on self-regulation.     

TEACHING ABOUT LOSS

In this article, we develop a case for teaching about loss as part of social and behavioral science curricula. We discuss the first author's development of a class that focuses on loss and trauma. This class emphasizes the view of loss as a pervasive aspect of human life and that it is the core experience for other phenomena, including trauma and chronic illness. The course involves a component in which students write about some loss experience that may reflect their personal life. This component permits many students to express pain, sometimes for one of the first times in their lives, regarding the events in question and relate their experience to what they have learned in the course. Significant features of the course are a score of videos and guest presentations, documenting the diversity of loss and people's myriad ways of coping with loss. It is argued that the course and students' experiences in fulfilling course requirements speak to the gains that may be realized by honest, in-depth probing of losses within the context of psychological and other literatures.     

Internal stress and defect-related free volume in submicrocrystalline Ni studied by neutron diffraction and difference dilatometry

A combined study of neutron diffraction and difference dilatometry on submicrocrystalline Ni prepared by high pressure torsion aims at studying the anisotropic behaviour during dilatometry and its relation to internal stress and structural anisotropy. Macroscopic stresses were undetectable in the dilatometer samples. Along with specific tests such as post cold-rolling, this shows that an observed anisotropic length change upon annealing is not caused by internal stress, but can be explained by the inherent microstructure, i.e. the anisotropic annealing of relaxed vacancies at grain boundaries of shape-anisotropic crystallites.     

Outsourcing inspiration: The performance effects of ideological messages from leaders and beneficiaries

Although ideological messages are thought to inspire employee performance, research has shown mixed results. Typically, ideological messages are delivered by leaders, but employees may be suspicious of ulterior motives—leaders may merely be seeking to inspire higher performance. As such, we propose that these messages are often more effective when outsourced to a more neutral third party—the beneficiaries of employees’ work. In Study 1, a field quasi-experiment with fundraisers, ideological messages from a beneficiary—but not from two leaders—increased performance. In Study 2, a laboratory experiment with an editing task, participants achieved higher task and citizenship performance when an ideological message was delivered by a speaker portrayed as a beneficiary vs. a leader, mediated by suspicion. In Study 3, a laboratory experiment with a marketing task, the beneficiary source advantage was contingent on message content: beneficiaries motivated higher task and citizenship performance than leaders with prosocial messages but not achievement messages.