The New Interventionism

This paper focuses on the boundaries of political sovereignty, one key aspect of global political justice and an important background condition to the issues of global economic justice treated in the other papers of this volume. I first present an interpretive summary of the traditional arguments against and for intervention, stressing, to a greater extent than is usual, the consequentialist character of the ethics of intervention. It makes a difference whether we think that an intervention will do more good than harm, and some of the factors that determine the outcome are matters of strategy and institutional choice. I then explore the significance of a key factor that makes for much of what is new in the new interventionism: the role of multilateral and particularly U.N. authorization and implementation. I argue that the more salient role of the United Nations should lead us to a more expansive tolerance of international intervention and that global standards of justice, both political and economic, can therefore be more widely enforced against claims to national autonomy.     

Judging Cumulative Risk1

The accuracy of young adults' perceptions of how cumulative risks to life, health, and property change over time was tested by asking subjects to judge the long-term probabilities associated with different periods of exposure to risks that are very small in the short term. Process analyses revealed evidence that strategy choice and associated accuracy depended on context and framing variables. Subjects asked to judge conjunctive probabilities adopted a variety of strategies, all of which failed to yield consistently accurate long-term probability judgments. However, subjects asked to judge disjunctive probabilities often reframed the probability questions into questions about the expected number of times the hazard would strike, which they could answer more accurately. Implications of the research for promoting public understanding of the long-term implications of cumulative risks are discussed.     

A developmental study of attribute encoding in free recall

In two studies, subjects from second-grade, sixth-grade, and college were presented lists of unrelated words for single-trial free recall. Embedded in the list were critical items that were either semantically or phonemically related or else were completely unrelated. The sets of related items were either massed or distributed in the longer list. For second-graders, recall of Phonemic words was better than recall of Semantic words while the reverse was true for sixth-graders. Recall of Semantic distributed words by second-graders and of Phonemic distributed words by sixth-graders did not differ from recall of unrelated words. College students recalled Phonemic and Semantic words equally well and all related words better than unrelated words. Developmental trends were seen in the salience of particular attributes and in the utilization of low salient attributes.     

What is the Role of the Arts in Medical Education and Patient Care? A Survey-based Qualitative Study

To inform medical education reform efforts, we systematically collected information on the level of arts and humanities engagement in our medical school community. Attitudes regarding incorporating arts and humanities-based teaching methods into medical education and patient care were also assessed. An IRB-approved survey was electronically distributed to all faculty, residents, fellows, and students at our medical school. Questions focused on personal practice of the arts and/or humanities, as well as perceptions of, and experience with formally incorporating these into medical teaching. Of 13,512 community members surveyed, 2,775 responded (21% overall response rate). A majority of respondents agreed or strongly agreed that medical education and patient care could be "enhanced" by the integration of the arts (67% and 74% respectively). There was enthusiastic support for the creation of a formal program in the arts at our medical school (72 %). Integration of the arts into medical education may have a role in improving the quality of medical training and would likely be well received by teachers and learners.     

If you want to know, consider asking: how likely is it that patients will hurt themselves in the future?

Although self-harming behavior is a common and costly problem for psychiatric inpatients released from the hospital, standardized tools that assess patients' risk for self-harm are rarely used in clinical settings. In this study of dually diagnosed psychiatric inpatients (N = 147), we assessed the utility of patients' self-perceptions of risk in predicting self-harm in the community. Patients' self-perceptions of risk predicted self-harm 8 weeks after discharge from the hospital (Lag 1; area under the curve [AUC] = 0.75). Self-perceptions of risk at the 8-week interview also predicted self-harm 2 months later (Lag 2; AUC = 0.72). Self-perceived risk added predictive utility above and beyond scores on a measure of depression and seemed to capture changes in risk state over time. The results suggest that inpatients can accurately perceive their own risk and therefore may be important collaborators in the risk management process.     

Glucocorticoids are required for extinction of predator stress-induced hyperarousal

Background

The role of glucocorticoids in extinction of traumatic memories has not been fully characterized despite its potential as a therapeutic target for acquired posttraumatic stress disorder (PTSD). The predator stress paradigm allows us to determine whether glucocorticoids mediate the extinction of both context-dependent and context-independent fear memories.

Methods

Male C57BL/6J mice were exposed to a predator (cat) then repeatedly exposed to the predator stress context in the absence of the cat. Context-dependent (associative) fear memory was assessed as suppression of activity during re-exposure to the predator stress context without the cat (extinction trials). Context-independent fear (non-associative) was assessed seven days after extinction trials using measures of hyperarousal and anxiety-like behaviours in environments unlike the predator stress context. To assess the role of glucocorticoids, mice were injected with metyrapone (50 mg/kg) 90 min prior to extinction trials in predator stressed mice and context-dependent and context-independent fear memories were assessed. Finally, metyrapone-treated predator stressed mice were injected with corticosterone (5 or 10 mg/kg) immediately following extinction trials and context-dependent and context-independent fear memories were assessed.

Results

Repeated re-exposure to the predator stress context without the cat present extinguished context-dependent fear memory, and also reduced hyperarousal, a generalized, chronic PTSD-like symptom. We show that extinction of context-independent predator stress-induced hyperarousal is dependent on endogenous glucocorticoids during the extinction trials. Furthermore, the inhibition of extinction by metyrapone on startle amplitude was reduced by exogenous administration of corticosterone following extinction trials. Overall, these data implicate glucocorticoids in the extinction of hyperarousal, a core symptom of PTSD.