Stuck in the middle: the many moral challenges with bariatric surgery

Bariatric surgery is effective on short- and medium-term weight loss, reduction of comorbidities, and overall mortality. A large and increasing portion of the population is eligible for bariatric surgery, which increases instant health care costs. A review of the literature identifies a series of ethical challenges: unjust distribution of bariatric surgery, autonomy and informed consent, classification of obesity and selecting assessment endpoints, prejudice among health professionals, intervention in people's life-world, and medicalization of appearance. Bariatric surgery is particularly interesting because it uses surgical methods to modify healthy organs, is not curative, but offers symptoms relief for a condition that it is considered to result from lack of self-control and is subject to significant prejudice. Taking the reviewed ethical issues into account is important when meeting persons eligible for bariatric surgery, as well as in the assessment of and decision making on surgery for obesity.     

The tight coupling between category and causal learning

The main goal of the present research was to demonstrate the interaction between category and causal induction in causal model learning. We used a two-phase learning procedure in which learners were presented with learning input referring to two interconnected causal relations forming a causal chain (Experiment 1) or a common-cause model (Experiments 2a, b). One of the three events (i.e., the intermediate event of the chain, or the common cause) was presented as a set of uncategorized exemplars. Although participants were not provided with any feedback about category labels, they tended to induce categories in the first phase that maximized the predictability of their causes or effects. In the second causal learning phase, participants had the choice between transferring the newly learned categories from the first phase at the cost of suboptimal predictions, or they could induce a new set of optimally predictive categories for the second causal relation, but at the cost of proliferating different category schemes for the same set of events. It turned out that in all three experiments learners tended to transfer the categories entailed by the first causal relation to the second causal relation.     

A two-week monitoring of self-reported arousal, worry and attribution among persons with annoyance attributed to electrical equipment and smells

Non-patients attributing annoyance to either smells (smell annoyed; SA, n= 29) or electrical equipment (electrically annoyed; EA, n= 17), or both (generally annoyed; GA, n= 38), were monitored for 2 weeks through daily self-ratings of arousal (stress), sleep disturbances, health complaints, worry about hypersensitivity reactions, avoidance behaviors, and attributions of health complaints to electrical equipment and smells. In parallel, a demographically matched reference group was followed (n= 56). GA persons reported higher arousal (stress), more subjective health complaints, and more sleep disturbances than the other groups. About 60% in the GA and EA groups reported intentional avoidance behavior, compared to 31% in the SA group and 2% of the referents. Worry and attribution to environmental factors was also more frequent among GA persons than in the other groups. Thus, even at sub-clinical levels, environmental annoyance generalized to several triggers seems to be associated with behaviors commonly observed among patients with idiopathic environmental intolerance.     

The Incredible Years Teacher Classroom Management Programme in Kindergartens: Effects of a Universal Preventive Effort

The purpose of this study was to identify preventive effects of the Incredible Years (IY) teacher classroom management (TCM) programme, which is employed in Norwegian kindergartens for 3-year-old to 6-year-old children. IY TCM is a universal preventive intervention intended to reduce the frequency of inappropriate types of behaviour and support children’s social- and emotional competence in kindergartens and schools. IY TCM was implemented in 46 kindergartens and compared to 46 matched kindergartens that did not receive the intervention. A total of 1049 children took part in the trial, 511 from the IY TCM group and 538 from the comparison group. Children’s behaviours were measured using well-validated instruments at the beginning and end of a school-year cycle, approximately 9 months later. Findings showed promising reductions in aggression, internalising and attention problems, and increases in social competence in the IY TCM kindergartens. In a sub-sample comprising children who scored equal to or above the 90th percentile on aggressive behaviour before the intervention, promising developments were found in social competence among the children in IY TCM kindergartens. The IY TCM lead to promising preventive effects in young children’s aggressive behaviours, internalisation, attention problems, and social competence in kindergartens in Norway. However, even if the changes were statistically significant, effect sizes were small. For children with severe behaviour problems, few positive results were found.     

Do Equal Rights for a Minority Affect General Life Satisfaction?

While previous research examines how institutions matter for general life satisfaction and how specific institutions embodying equal rights for gay people matter for the life satisfaction of gays, we combine these two issues to analyze how the latter type of institutions relates to general life satisfaction. The question is how people in general are affected by laws treating everyone equally irrespective of sexual orientation. We find that legal recognition of partnership, marriage and adoption rights, as well as an equal age of consent, relate positively to general life satisfaction. Consequently, same-sex marriage and similar reforms come at no “welfare” cost to society at large—if anything, the opposite appears to hold. We further build on previous research showing positive effects of economic freedom on happiness and on tolerance towards gay people and interact our rights measure with economic freedom. This reveals that the positive effect on general happiness of equal rights mainly appears in countries with low economic freedom. This likely follows because minority rights are perceived to indicate openness to much-desired reforms in other areas.     

Non-dominant hand use increases completion time on part B of the Trail Making Test but not on part A

The Trail Making Test (TMT) is used in neuropsychological clinical practice to assess aspects of attention and executive function. The test consists of two parts (A and B) and requires drawing a trail between elements. Many patients are assessed with their non-dominant hand because of motor dysfunction that prevents them from using their dominant hand. Since drawing with the non-dominant hand is not an automatic task for many people, we explored the effect of hand use on TMT performance. The TMT was administered digitally in order to analyze new outcome measures in addition to total completion time. In a sample of 82 healthy participants, we found that non-dominant hand use increased completion times on the TMT B but not on the TMT A. The average completion time increased by almost 5 seconds, which may be clinically relevant. A substantial number of participants who performed the TMT with their non-dominant hand had a B/A ratio score of 2.5 or higher. In clinical practice, an abnormally high B/A ratio score may be falsely attributed to cognitive dysfunction. With our digitized pen data, we further explored the causes of the reduced TMT B performance by using new outcome measures, including individual element completion times and interelement variability. These measures indicated selective interference between non-dominant hand use and executive functions. Both non-dominant hand use and performance of the TMT B seem to draw on the same, limited higher-order cognitive resources.