Development and the epigenome: the ‘synapse’ of gene–environment interplay

This paper argues that there is a revolution afoot in the developmental science of gene–environment interplay. We summarize, for an audience of developmental researchers and clinicians, how epigenetic processes – chromatin structural modifications that regulate gene expression without changing DNA sequences – may offer a strong, parsimonious account for the convergence of genetic and contextual variation in the genesis of adaptive and maladaptive development. Epigenetic processes may play a plausible explanatory role in understanding: divergent trajectories and sexual dimorphisms in brain development; statistical interactions between genes and environments; the biological embedding of early psychosocial adversities; the linkages of such adversities to disorders of mental health; the striking individual variation in the strength of those linkages; the molecular origins of critical and sensitive periods; and the transgenerational inheritance of risk and protection. Taken together, these arguments converge in a claim that epigenetic processes constitute a promising and illuminating point of connection – a ‘synapse’ – between genes and environments.     

Conceptualising mental health in the United Arab Emirates: the perspective of traditional healers

Substantial investments in health-care have ensured the widespread availability of allopathic medical services across the United Arab Emirates (UAE). However, in spite of this accessibility traditional healers (Mutawa) continue to play a significant, albeit, unofficial role in the UAE's health sector. Citizens routinely consult traditional healers for problems that might, from a western biomedical perspective, be considered psychiatric conditions. This qualitative study explores traditional healers' conceptualisations of mental health problems, discussing their perspectives on phenomenology, aetiology, intervention and outcome. Notably, traditional healers distinguished between biomedical illness and states they attributed to demonological or metaphysical causes. The Islamic spiritual narrative was central to discussions of aetiology, intervention and outcome. Greater integration of traditional healers within the UAE's mental health-care services would, in many cases, improve patient experience and outcomes.     

Doctors,Patients, and Nudging in the Clinical Context—Four Views on Nudging and Informed Consent

In an analysis of recent work on nudging we distinguish three positions on the relationship between nudging founded in libertarian paternalism and the protection of personal autonomy through informed consent. We argue that all three positions fail to provide adequate protection of personal autonomy in the clinical context. Acknowledging that nudging may be beneficial, we suggest a fourth position according to which nudging and informed consent are valuable in different domains of interaction.