Medical Education for Social Justice: Paulo Freire Revisited

Although social justice is an integral component of medical professionalism, there is little discussion in medical education about how to teach it to future physicians. Using adult learning theory and the work of Brazilian educator Paulo Freire, medical educators can teach a socially-conscious professionalism through educational content and teaching strategies. Such teaching can model non-hierarchical relationships to learners, which can translate to their clinical interactions with patients. Freirian teaching can additionally foster professionalism in both teachers and learners by ensuring that they are involved citizens in their local, national and international communities.     

Canavan disease: a white matter disorder

Breakdown of oligodendrocyte-neuron interactions in white matter (WM), such as the loss of myelin, results in axonal dysfunction and hence a disruption of information processing between brain regions. The major feature of leukodystrophies is the lack of proper myelin formation during early development or the onset of myelin loss late in life. These early childhood WM diseases are described as hypomyelination or dysmyelination arising from a primary block in normal myelin synthesis because of a genetic mutation expressed in oligodendrocytes, or failure in myelination secondary to neuronal or astroglial dysfunctions (van der Knaap 2001 Dev. Med. Child Neurol. 43:705-712). Here, we describe the pathophysiological parameters of Canavan disease (CD), caused by genetic mutations of the aspartoacylase (ASPA) gene, a metabolic enzyme restricted in the central nervous system (CNS) to oligodendrocytes. CD presents pathophysiological dysfunctions similar to diseases caused by myelin gene mutations, such as Pelizaeus-Merzbacher disease (PMD) and several animal models, such as myelin deficient rat (md), jimpy (jp), shiverer (sh), and quaking (qk viable) mutant mice. These single gene mutations have pleiotropic effects, whereby the alteration of one myelin gene expression disrupts functional expression of other oligodendrocyte genes with an outcome of hypomyelination/dysmyelination. Among all of the known leukodystrophies, CD is the first disorder, which was approved and tested for the adeno-associated virus vector (AAV)-ASPA gene therapy (Leone et al. 2000 Ann. Neurol. 48:27-38; Janson et al. 2001 Trends Neurosci. 24:706-712) without much success following the first two attempts. ASPA gene delivery attempts in animal models have shown a lowering of N-acetyl L-aspartate and a change in motor functions, while sponginess of the WM, a characteristic of CD remained unchanged (Matalon et al. 2003 Mol. Ther. 7 (5, Part 1):580-587; McPhee et al. 2005 Brain Res. Mol. Brain Res. 135:112-121) even with better viral serotype and delivery of the gene during early phase of development (Klugmann et al. 2005 Mol. Ther. 11:745-753). While different approaches are being sought for the success of gene therapy, there are pivotal developmental questions to address regarding the specific regions of the CNS and cell lineages that become the target for the onset and progression of CD symptoms from early to late stages of development.     

“The interviewer is a machine!” Investigating the effects of conventional and technology-mediated interview methods on interviewee reactions and behavior

Despite the growing number of organizations interested in the use of asynchronous video interviews (AVIs), little is known about its impact on interviewee reactions and behavior. We randomly assigned participants (N = 299) from two different countries (Switzerland and India) to a face-to-face interview, an avatar-based video interview (with an avatar as a virtual recruiter), or a text-based video interview (with written questions) and collected data on a set of self-rated and observer-rated criteria. Overall, we found that whereas participants reported more negative reactions towards the two asynchronous interviews, observer ratings revealed similar performance across the three interviews and lower stress levels in the two AVIs. These findings suggest that despite technology-mediated interview methods still not being well-accepted, interviewees are not at a disadvantage when these methods are used in terms of how well interviewees perform and how stressed they appear to external observers. Implications are discussed.     

The perceived vulnerability to disease scale: Cross-cultural measurement invariance and associations with fear of COVID-19 across 16 countries

Using cross-sectional data from N = 4274 young adults across 16 countries during the COVID-19 pandemic, we examined the cross-cultural measurement invariance of the perceived vulnerability to disease (PVD) scale and tested the hypothesis that the association between PVD and fear of COVID-19 is stronger under high disease threat [that is, absence of COVID-19 vaccination, living in a country with lower Human Development Index (HDI) or higher COVID-19 mortality]. Results supported a bi-factor Exploratory Structural Equation Modeling model where items loaded on a global PVD factor, and on the sub-factors of Perceived Infectability and Germ Aversion. However, cross-national invariance could only be obtained on the configural level with a reduced version of the PVD scale (PVD-r), suggesting that the concept of PVD may vary across nations. Moreover, higher PVD-r was consistently associated with greater fear of COVID-19 across all levels of disease threat, but this association was especially pronounced among individuals with a COVID-19 vaccine, and in contexts where COVID-19 mortality was high. The present research brought clarity into the dimensionality of the PVD measure, discussed its suitability and limitations for cross-cultural research, and highlighted the pandemic-related conditions under which higher PVD is most likely to go along with psychologically maladaptive outcomes, such as fear of COVID-19.     

Use of the Beck Depression Inventory-II with Adolescent Psychiatric Outpatients

To provide information on the use of the Beck Depression Inventory-II (BDI-II) with adolescents, the BDI-II was administered to 105 male and 105 female outpatients between 12 and 18 years old who were seeking psychiatric treatment. The internal consistency of the BDI-II was high (coefficient = .92). The mean BDI-II total score of the girls was approximately 5 points higher than that of the boys (p < .001), and age (years) was positively correlated with the BDI-II total scores (r = .18, p < .01). An iterated principal-factor analysis identified three factors, but only the Cognitive and Somatic-Affective factors were generalizable.     

Conceptualizing Attachment Trauma: Exploring Emotional Vulnerabilities among Disaster Affected Children of Gujarat

This study compares attachment trauma and psychological adjustment of child survivors of an earthquake and social violence in Gujarat (n = 127). In particular it explores attachment style/s associated with the two disaster traumas and tries to explicate, what these tell us about the particular vagaries of trauma. Results show larger number of insecurely attached children in the disaster trauma sample and the dismissing attachment style dominates particularly in the earthquake sample whereas in the riots sample one can see a presence of what can be termed as a ‘mixed attachment’ style-vacillation between dismissing and preoccupied states of mind. The implications of these findings for a conceptualization of attachment trauma are discussed in details.     

A new American dilemma? The effect of ethnic identification and public service on the national inclusion of ethnic minorities

Three experiments integrate research from political science and social psychology to examine the consequences of two competing visions of American national identity. American identity has been defined not only in terms of shared ethnocultural heritage originating in Europe (the ethnocultural prototype) but also in terms of shared commitment to civic service (the civic responsibility prototype). Three experiments tested the consequence of highlighting each of these national prototypes on perceivers' inclusion of ethnic minorities as legitimately American. Experiments 1–3 showed that highlighting ethnic minorities' allegiance to their ethnic subgroup (versus downplaying it) challenges the ethnocultural prototype and makes ethnic minorities appear less American. Process data showed that this effect was mediated by increased threats to American distinctiveness. By contrast, emphasizing ethnic minorities' national service (versus local community service) highlights ethnic minorities' fit with the civic responsibility prototype and makes ethnic minorities appear more American (Experiments 2–3). Process data showed that this effect was mediated by enhanced American distinctiveness. Collectively, these experiments highlight how inclusion of ethnic minorities in the nation can wax and wane depending on which definition of national character is salient in the social context. Copyright © 2012 John Wiley & Sons, Ltd.     

The Rāga Bhāva in the Sāṁkhya Kārikā: Rectifying an Age-Old Mistake

The last foot of the 23rd verse of the Sā?khya Kārikā (SK)—‘tāmasam asmāt viparyastam’—is in need of reinterpretation. Prevailing interpretations are generally based on the primary meaning of the verse. In that sense, it is understood as a declaration of the four tāmasika bhāva that are contrary to the sāttvika ones. Taking the primary meaning of the verse is problematic because it contradicts the gu?a-bhāva coherence required by the doctrine of satkārya. The doctrine of satkārya is one of the foundational principles of Sā?khya. The avirāga or rāga bhāva shows coherence to rajas rather than tamas. I show that the verse needs to be interpreted by taking the secondary meaning. Accordingly, avirāga or rāga is established as a bhāva of rajas rather than tamas. Further, I also show that the idea of bhāva in the Sā?khya Kārikā and the Bhagavadgītā may be closely related.     

Prior Related Work Experience and Job Performance: Role of personality

In contrast to the general notion, recent studies presented a negative or insignificant relationship between prior related work experience (PRWE) and job performance (JP) and suggestively attributed the theoretically inconsistent results to individual factors. Using a sample of 688 sales persons in the insurance industry, the present study found support for the positive relationship between PRWE and JP. Further, the study found the moderation effect of personality factors on the above relationship. Implication of the study to the practitioners and the academia is discussed.     

Perception of individuality in bat vocal communication: discrimination between, or recognition of, interaction partners?

Different cognitive processes underlying voice identity perception in humans may have precursors in mammals. A perception of vocal signatures may govern individualised interactions in bats, which comprise species living in complex social structures and are nocturnal, fast-moving mammals. This paper investigates to what extent bats recognise, and discriminate between, individual voices and discusses acoustic features relevant for accomplishing these tasks. In spontaneous presentation and habituation–dishabituation experiments, we investigated how Megaderma lyra perceives and evaluates stimuli consisting of contact call series with individual-specific signatures from either social partners or unknown individuals. Spontaneous presentations of contact call stimuli from social partners or unknown individuals elicited strong, but comparable reactions. In the habituation–dishabituation experiments, bats dishabituated significantly to any new stimulus. However, reactions were less pronounced to a novel stimulus from the bat used for habituation than to stimuli from other bats, irrespective of familiarity, which provides evidence for identity discrimination. A model separately assessing the dissimilarity of stimuli in syllable frequencies, syllable durations and inter-call intervals relative to learned memory templates accounted for the behaviour of the bats. With respect to identity recognition, the spontaneous presentation experiments were not conclusive. However, the habituation–dishabituation experiments suggested that the bats recognised voices of social partners as the reaction to a re-habituation stimulus differed after a dishabituation stimulus from a social partner and an unknown bat.