The Ethics of Smart Pills and Self-Acting Devices: Autonomy,Truth-Telling,and Trust at the Dawn of Digital Medicine

Digital medicine is a medical treatment that combines technology with drug delivery. The promises of this combination are continuous and remote monitoring, better disease management, self-tracking, self-management of diseases, and improved treatment adherence. These devices pose ethical challenges for patients, providers, and the social practice of medicine. For patients, having both informed consent and a user agreement raises questions of understanding for autonomy and informed consent, therapeutic misconception, external influences on decision making, confidentiality and privacy, and device dependability. For providers, digital medicine changes the relationship where trust can be verified, clinicians can be monitored, expectations must be managed, and new liability risks may be assumed. Other ethical questions include direct third-party monitoring of health treatment, affordability, and planning for adverse events in the case of device malfunction. This article seeks to lay out the ethical landscape for the implementation of such devices in patient care.     

Contextual connections within puns: effects on perceived humor and memory

The supposition that perceived humor or cleverness would be enhanced by adding separate content to the alternative meanings of a pun was explored, using Tom Swifties as the research vehicle. Because detecting a punning word relationship might induce arousal, requiring more effort and attentional resources for processing than noting a contextual connection, memory strength for adverbs was also examined using a recognition procedure. Five studies were conducted in which college students were asked to judge 24 Swifties (content counterbalanced across participants) in which presence of pun and context were manipulated. The punning relationship was primarily responsible for perceived humor and cleverness. Presence of a pun also enhanced memory strength (d') as long as the familiarization task focused on humor and cleverness. Coherent context enhanced perceived cleverness inconsistently. It was suggested that a coherent contextual connection may make a greater contribution in more lengthy forms of pun-based word play, such as fables or "shaggy dog" stories.     

Birthweight-discordance and differences in early parenting relate to monozygotic twin differences in behaviour problems and academic achievement at age 7

This longitudinal monozygotic (MZ) twin differences study explored associations between birthweight and early family environment and teacher-rated behaviour problems and academic achievement at age 7. MZ differences in anxiety, hyperactivity, conduct problems, peer problems and academic achievement correlated significantly with MZ differences in birthweight and early family environment, showing effect sizes of up to 2%. As predicted by earlier research, associations increased at the extremes of discordance, even in a longitudinal, cross-rater design, with effect sizes reaching as high as 12%. As with previous research some of these non-shared environmental (NSE) relationships appeared to operate partly as a function of SES, family chaos and maternal depression. Higher-risk families generally showed stronger negative associations.     

Categorical and dimensional reports of experienced affect to emotion-inducing pictures in depression

Self-reported affect to positive and negative emotional pictures was contrasted in people with major depressive disorder (MDD) and never-depressed control participants (n = 25 in each group). The results revealed significant differences in response to positive images (reduced arousal, less pleasant valence, decreased happiness, increased sadness) in MDD but no clear group differences in response to negative stimuli. Extending earlier findings of reduced responsiveness to positive, but not negative, stimuli in MDD (D. M. Sloan, M. E. Strauss, S. W. Quirk, & M. Satajovik, 1997; D. M. Sloan, M. E. Strauss, & K. L. Wisner, 2001), the data indicate that blunted response to positive stimuli is found when both categorical and dimensional ratings are elicited. Further, the data replicate earlier findings of elevated sadness reports to positive stimuli (J. Rottenberg, K. L. Kasch, J. J. Gross, & I. H. Gotlib, 2002), which may reflect broader difficulties in regulating emotions in MDD.     

Superior performance of blind compared with sighted individuals on bimanual estimations of object size

Five preliminary experiments on sighted individuals revealed marked overestimation on an object size-estimation task using a bimanual response. These experiments ruled out the possibility that overestimation was due to the mode of visual presentation (whether two-dimensional or three-dimensional), the input modality (visual or kinesthetic), or the influence of other visual cues. The main experiment then investigated whether these distortions are due to visual experience by using a variant of the same task to test 24 blind and 24 sighted control participants. Remarkably, the sighted control participants overestimated object size, on average, but the blind participants did not. A follow-up experiment demonstrated that visual memory was the primary influence causing the size over-estimations. We conclude that blind individuals are more accurate than sighted individuals in representing the size of familiar objects because they rely on manual representations, which are less influenced by visual experience than are visual memory representations.     

Investigator ratings of ADHD symptoms during a randomized, placebo-controlled trial of atomoxetine: a comparison of parents and teachers as informants

This study compared investigator ratings of ADHD symptoms based on interviews with parents and teachers during a doubleblind, placebo-controlled study of atomoxetine. Investigators completed the ADHD Rating Scale: Investigator (ADHDRS-I) based on separate semistructured interviews with the primary caretaker and teacher of the participant. Interviews were conducted at Visits 2 to 7 during a double-blind treatment protocol comparing atomoxetine (N= 10) and placebo (N= 6). Both parent and teacher-based ratings were sensitive to change in ADHD symptoms with atomoxetine treatment. Parent-based assessment differentiated significantly between treatment with atomoxetine and placebo, whereas teacher-based assessment was less sensitive to change. Parents and teachers showed good agreement on change in ADHDRS-I scores. Investigator ratings based on parent- and teacher-report were sensitive to change in symptoms of ADHD during treatment with atomoxetine. Despite good agreement between parent- and teacher-based ratings of symptom change, parent-based ADHD symptom ratings are more sensitive to symptom change.     

Judgments of remembering: the revelation effect in children and adults

When items on a recognition test are presented as a series of increasingly complete fragments rather than being presented initially in their fully intact form, adults' judgments of recognition exhibit an increased tendency to judge items as "old," an illusion of recognition referred to as the revelation effect. The present study used pictorial stimuli to test for a revelation effect with 4-year-olds, 8-year-olds, and adults (N = 76). A reliable revelation effect was found at all ages tested, indicating that the complex fluency-of-processing discrepancy detection and attribution mechanisms thought to be responsible for the effect function similarly across an age range from 4-years-of-age through adulthood. It was also found that the recognition decisions of the 8-year-olds and the adults were affected by how quickly they were able to identify a picture during the revelation phase of the recognition test. This effect was not found with the 4-year-olds, suggesting an age difference in the awareness and strategic use of an implicit memory effect when making explicit judgments of recognition.     

An exploratory study of undergraduates' attributions of success or failure on spatial tests

Seven spatial tests from the CTY Spatial Test Battery and four subscales of an attribution scale were administered to 23 female and 28 male undergraduates. Three hypotheses were tested. The seven spatial tests and three of the attribution subscales were found reliable; sex differences were found for the spatial tests but not the attribution scales; and subjects' attributions did not predict spatial performance.     

学习类型的理论研究简介

本文系统地阐述了学习类型的有关理论研究,即对学习类型的涵义与特征、构成要素及分类、研究方法和研究趋势作了探讨,便于人们了解学习类型的有关理论问题及研究概况。