Ethical challenges in the COVID-19 research context: a toolkit for supporting analysis and resolution

ABSTRACTCOVID-19 is compromising all aspects of society, with devastating impacts on health, political, social, economic and educational spheres. A premium is being placed on scientific research as the source of possible solutions, with a situational imperative to carry out investigations at an accelerated rate. There is a major challenge not to neglect ethical standards, in a context where doing so may mean the difference between life and death. In this paper we offer a rubric for considering the ethical challenges in COVID-19 related research, in the form of an ethics toolkit for global research developed at the University of Edinburgh in collaboration with more than 200 global researchers from around the world. This toolkit provides a framework to support confrontation of ethical conflicts through the integrated and iterative analysis of Place, People, Principles and Precedents, throughout the research journey. Two case analyses are offered to exemplify the utility of the toolkit as a flexible and dynamic tool to promote ethical research in the context of COVID-19.     

How do you think she feels? Vulnerability in empathy and the role of attention in school‐aged children born extremely preterm

The aim of this study was to examine empathic competence in children born extremely preterm (EP, <28 weeks) given vulnerabilities in social relationships. Empathy in typically developing children is mediated by executive functions. Executive functioning is also impaired in preterm children. Of particular interest in this study are the attentional components of executive functioning as mediators of empathic development. Thirty‐two 7‐year‐old EP children and 40 age‐matched term children participated in the Project K.I.D.S program and completed the Kids Empathy Development Scale (KEDS), Wechsler Intelligence Scale for Children (WISC‐IV), and Test of Everyday Attention for Children (TEA‐Ch). Children born extremely preterm exhibited poorer performance on all measures. The mediating role of attention in empathy competence was not supported by mediation modelling when FSIQ was controlled. As predicted, the EP group showed weaker empathic development relative to typically developing children. They also showed poorer attentional abilities. However, the effect of preterm birth on empathy was not mediated by executive‐level attention. The cognitive mechanisms underpinning poor empathy competence in EP children remain unclear. Future research needs to examine the role of inhibition, social–emotional recognition, and regulation.     

The reproduction of vertical and oblique orientations in the visual, haptic, and somatovestibular systems

This study investigates whether the vertical orientation may be predominantly used as an amodal reference norm by the visual, haptic, and somato-vestibular perceptual systems to define oblique orientations. We examined this question by asking the same sighted adult subjects to reproduce, in the frontal (roll) plane, the vertical (0°) and six oblique orientations in three tasks involving different perceptual systems. In the visual task, the subjects adjusted a moveable rod so that it reproduced the orientation of a visual rod seen previously in a dark room. In the haptic task, the blindfolded sighted subjects scanned an oriented rod with one hand and reproduced its orientation, with the same hand, on a moveable response rod. In the somato-vestibular task, the blindfolded sighted subjects, sitting in a rotating chair, adjusted this chair in order to reproduce the tested orientation of their own body. The results showed that similar oblique effects (unsigned angular error difference between six oblique orientations and vertical orientation) were observed across the three tasks. However, there were no positive correlations between the visual, haptic,     

A placebo-controlled randomized trial of D-cycloserine augmentation of cue exposure therapy for smoking cessation

Recent studies underscore the importance of studying d-cycloserine (DCS) augmentation under conditions of adequate cue exposure treatment (CET) and protection from reconditioning experiences. In this randomized trial, we evaluated the efficacy of DCS for augmenting CET for smoking cessation under these conditions.

Sixty-two smokers attained at least 18 hours abstinence following 4 weeks of smoking cessation treatment and were randomly assigned to receive a single dose of DCS (n=30) or placebo (n=32) prior to each of two sessions of CET. Mechanistic outcomes were self-reported cravings and physiologic reactivity to smoking cues. The primary clinical outcome was 6-week, biochemically-verified, continuous tobacco abstinence.

DCS, relative to placebo, augmentation of CET resulted in lower self-reported craving to smoking pictorial and in vivo cues (d = 0.8 to 1.21) in a relevant subsample of participants who were reactive to cues and free from smoking-related reconditioning experiences. Select craving outcomes were correlated with smoking abstinence, and DCS augmentation was associated with a trend toward a higher continuous abstinence rate (33% vs. 13% for placebo augmentation).

DCS augmentation of CET can significantly reduce cue-induced craving, supporting the therapeutic potential of DCS augmentation when applied under appropriate conditions for adequate extinction learning.     

The Kids' Empathic Development Scale (KEDS): A multi‐dimensional measure of empathy in primary school‐aged children

Empathy is an essential building block for successful interpersonal relationships. Atypical empathic development is implicated in a range of developmental psychopathologies. However, assessment of empathy in children is constrained by a lack of suitable measurement instruments. This article outlines the development of the Kids' Empathic Development Scale (KEDS) designed to assess some of the core affective, cognitive and behavioural components of empathy concurrently. The KEDS assesses responses to picture scenarios depicting a range of individual and interpersonal situations differing in social complexity. Results from 220 children indicate the KEDS measures three related but distinct aspects of empathy that are also related to existing measures of empathy and cognitive development. Scores on the KEDS show age and some gender‐related differences in the expected direction.