Ebola,epidemics, and ethics - what we have learned

The current Ebola epidemic has presented challenges both medical and ethical. Although we have known epidemics of untreatable diseases in the past, this particular one may be unique in the intensity and rapidity of its spread, as well as ethical challenges that it has created, exacerbated by its geographic location. We will look at the infectious agent and the epidemic it is causing, in order to understand the ethical problems that have arisen.     

Oculomotor atypicalities in Developmental Coordination Disorder

Children with Developmental Coordination Disorder (DCD) fail to acquire adequate motor skill, yet surprisingly little is known about the oculomotor system in DCD. Successful completion of motor tasks is supported by accurate visual feedback. The purpose of this study was to determine whether any oculomotor differences can distinguish between children with and without a motor impairment. Using eye tracking technology, visual fixation, smooth pursuit, and pro‐ and anti‐saccade performance were assessed in 77 children that formed three groups: children with DCD (aged 7–10), chronologically age (CA) matched peers, and a motor‐match (MM) group (aged 4–7). Pursuit gain and response preparation in the pro‐ and anti‐saccade tasks were comparable across groups. Compared to age controls, children with DCD had deficits in maintaining engagement in the fixation and pursuit tasks, and made more anti‐saccade errors. The two typically developing groups performed similarly, except on the fast speed smooth pursuit and antisaccade tasks, where the CA group outperformed the younger MM group. The findings suggest that children with DCD have problems with saccadic inhibition and maintaining attention on a visual target. Developmental patterns were evident in the typically developing groups, suggesting that the pursuit system and cognitive control develop with age. This study adds to the literature by being the first to systematically identify specific oculomotor differences between children with and without a motor impairment. Further examination of oculomotor control may help to identify underlying processes contributing to DCD. A video abstract of this article can be viewed at: https://youtu.be/NinXa2KlB4M . [Correction added on 27 January 2017, after first online publication: The video abstract link was added.]     

Medical Students’ Efforts to Integrate and/or Reclaim Authentic Identity: Insights from a Mask-Making Exercise

Medical students’ mask-making can provide valuable insights into personal and professional identity formation and wellness. A subset of first- and second-year medical students attending a medical school wellness retreat participated in a mask-making workshop. Faculty-student teams examined student masks and explanatory narratives using visual and textual analysis techniques. A quantitative survey assessed student perceptions of the experience. We identified an overarching theme: “Reconciliation/reclamation of authentic identity.” The combination of nonverbal mask-making and narrative offers rich insights into medical students’ experience and thinking. This activity promoted reflection and self-care, while providing insight regarding personal and professional development.     

Do Pantheistic,Theistic, and Deistic Views of God Moderate the Relationship Between Financial Strain and Physical Health Status?

The purpose of this study is to see if a pantheistic view of God (i.e., God is all around us in nature), a theistic view of God (i.e., God is the creator of the universe who protects us), and a deistic view of God (i.e., God created the universe and then left people to fend for themselves) moderate the relationship between chronic financial strain and three measures of health (self-rated health, the number of chronic conditions, and functional disability). The data come from a recent nationwide survey of adults of all ages (N = 2,768). The findings suggest that neither pantheistic nor theistic views of God offset the effects of financial strain on any of the health outcomes. In contrast, the data further reveal that the relationship between ongoing economic difficulties and all three health outcomes is more pronounced for study participants who have a deistic view of God.     

Counter‐intuitive moral judgement following traumatic brain injury

Several neurological patient populations, including traumatic brain injury (TBI), appear to produce an abnormally ‘utilitarian’ pattern of judgements to moral dilemmas; they tend to make judgements that maximize the welfare of the majority, rather than deontological judgements based on the following of moral rules (e.g., do not harm others). However, this patient research has always used extreme dilemmas with highly valued moral rules (e.g., do not kill). Data from healthy participants, however, suggest that when a wider range of dilemmas are employed, involving less valued moral rules (e.g., do not lie), moral judgements demonstrate sensitivity to the psychological intuitiveness of the judgements, rather than their deontological or utilitarian content (Kahane et al., Social Cognitive and Affective Neuroscience, 7, 2011, 393). We sought the moral judgements of 30 TBI participants and 30 controls on moral dilemmas where content (utilitarian/deontological) and intuition (intuitive/counter‐intuitive) were measured concurrently. Overall TBI participants made utilitarian judgements in equal proportions to controls; disproportionately favouring utilitarian judgements only when they were counter‐intuitive, and deontological judgements only when they were counter‐intuitive. These results speak against the view that TBI causes a specific utilitarian bias, suggesting instead that moral intuition is broadly disrupted following TBI.     

Improved Parent Cognitions Relate to Immediate and Follow-Up Treatment Outcomes for Children With ADHD-Predominantly Inattentive Presentation

We investigated treatment effects on parenting self-efficacy and parent cognitive errors, and whether these parent cognitions are related to short- and long-term outcomes in parenting behaviors in psychosocial treatment for youth with attention-deficit/hyperactivity disorder, predominantly inattentive presentation (ADHD-I). In a randomized controlled trial across two sites (University of California, San Francisco, and University of California, Berkeley), 199 children between the ages of 7 and 11 were randomized to the Child Life and Attention Skills (CLAS; n = 74) program, parent-focused treatment (PFT; n = 74), or treatment as usual (TAU; n = 51). Parents reported on self-efficacy, cognitive errors, positive parenting, and negative parenting prior to treatment, immediately after treatment, and in the next school year at follow-up. Compared to TAU, CLAS and PFT had higher posttreatment parenting self-efficacy, and CLAS alone had lower posttreatment parent cognitive errors. At follow-up, only CLAS had improved parent cognitive errors compared to TAU. No other between-group differences were found in parenting self-efficacy or cognitive errors. Improved parenting self-efficacy was associated with improved posttreatment negative parenting outcomes for PFT and CLAS, and improved parent cognitive errors were also related to improvements in positive and negative posttreatment parenting outcomes for CLAS. Posttreatment parenting self-efficacy mediated follow-up negative parenting outcomes for CLAS and posttreatment parent cognitive errors mediated improved follow-up positive and negative parenting outcomes for CLAS. PFT and CLAS led to enhanced parenting self-efficacy, and CLAS appears especially robust in improving parent cognitive errors both in the short and long term. Pathways provide support for the possibility of parent cognitions as mediators of treatment effects on parenting; clinical focus on such cognitions may be useful.     

Religious involvement and happiness: Assessing the mediating role of compassion and helping others

Research reveals that a number of different aspects of religious involvement are associated with happiness. However, researchers have yet to provide an overarching theoretical explanation for how multiple dimensions of religion might be associated with happiness. The purpose of this study is to develop and test a conceptual model that includes the following core hypotheses: (1) people who attend worship services more often tend to be more committed to their faith; (2) people who are more committed to their faith are more likely to be compassionate; (3) compassionate individuals are more likely to provide emotional support to significant others; and (4) people who provide support to others tend to be happier. Data from a recent nationwide survey in the United States (N = 3,010) provides support for each hypothesis. The theoretical implications of these finding are discussed.