Suicide compared to other causes of mortality in physicians

Physicians frequently are early adopters of healthy behaviors based on their knowledge and economic resources. The mortality patterns of physicians in the United States, particularly suicide, have not been rigorously described for over a decade. Previous studies have shown lower all-cause mortality among physicians yet reported conflicting results about cause-specific mortality such as suicide. In this study, we compared all-cause and cause-specific mortality in a sample of physicians to the age-gender matched general U.S. population from 1948 through 1998. We also compared the mortality experience across medical specialties. The risk of all-cause mortality was 56% lower than expected in men, and 26% lower in women, compared to the general population. Standardized mortality ratios (SMRs) were markedly lower for diseases strongly linked to smoking, e.g., cardiovascular diseases, respiratory diseases, and lung cancer. Suicide was the only cause of death where risk was greater than the general population. Overall, we found that physicians are at substantially lower risk of dying compared to the general population for all causes of death except suicide. The findings for suicide are strikingly different than other causes of death and should provide impetus for new research on the mental health of physicians.     

Index of suspicion: feeling not believing

Throughout the U.S., state laws require professionals who work with children to report cases of suspected child abuse to child protection services. Both practically and conceptually, however, significant problems arise from a lack of clarity regarding the threshold that has been set for reporting. Specifically, there is no consensus as to what constitutes reasonable suspicion, and little direction for how mandated reporters should gauge their legal and professional responsibilities when they harbor suspicion. In this paper we outline the context of the problem, discuss the nature and scope of its conceptual underpinnings, and offer recommendations for moving towards a concrete, practical solution.     

Senior capstone design and ethics: A bridge to the professional world

A senior level capstone design experience has been developed and offered with a particular emphasis on many of the professional issues raised in Accreditation Board for Engineering and Technology (ABET) Engineering Criterion IV. The course has sought to develop student awareness of the ethical foundation of the engineering profession, the global and societal framework within which engineers practice, and the environmental impact on engineering. The capstone design course also focused upon improving the technical communications skills of the graduating senior class with both extensive instruction in writing and multiple workshops dealing with the art of making an effective oral presentation. The effectiveness of the design course was assessed using Kirkpatrick’s model for evaluating training programs. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

Perceptions of Ethical Behaviour among Business Faculty in Canada

Faculty members at Canadian business schools were surveyed regarding their ethical perceptions of behaviours related to undergraduate instruction. Fifty-five behavioural statements were listed and respondents were asked to rate the extent to which they felt each behaviour was ethical or unethical. The only item that respondents endorsed as unequivocally unethical (90% indicated it was definitely unethical) was Becoming sexually involved with an undergraduate in one of your classes. We also compared the results of our sample to those of an American sample. Overall, an interesting pattern of differences emerged between the responses obtained in Canada and the U.S. In general, the direction of the significant differences was such that Canadian professors viewed the behaviours in question as less ethical than did their American counterparts.     

Hypothesis generation,probability judgment,and individual differences in working memory capacity

This research examined the role of working memory (WM) in probability judgment and hypothesis generation using a simulated task that involved estimating the likelihood that particular menu items would be ordered by customers at a dinner. Five main findings were observed. First, judgments of the likelihood of individual items were made relative to alternatives retrieved from long-term memory. Second, the number of alternatives retrieved was positively correlated with a measure of WM-capacity (the operation-span task). Third, participants' probability judgments were subadditive (summing to well over 100%). Fourth, the degree to which participants' judgments were subadditive was affected by the number and strength of the alternatives retrieved from long-term memory. Fifth, the degree to which participants were subadditive was negatively correlated with WM-capacity. The results suggest that individual differences in WM-capacity are fundamental to hypothesis generation and probability judgment.     

Laterality effects in perceived spatial location of hallucination-like voices

Aydin and colleagues reported a reversal of physiological 'right-ear advantage' in a group of right-handed patients with schizophrenia, using an auditory acuity test. In schizophrenia, auditory hallucinations may appear to be spatially located inside or outside the patient's head. Here we show, using virtual acoustic space techniques, that normal right-handed subjects have a right-ear advantage for correctly locating the 'source' of hallucination-like voices as from either inside or outside the head. We propose a model for understanding lateralised, external hallucinations in schizophrenia based upon reversal of normal cortical asymmetry for auditory spatial processing.     

Confirmatory factor analysis of the WMS-III in patients with temporal lobe epilepsy

Five competing models specifying the factor structure underlying the Wechsler Memory Scale-Third Edition (D. Wechsler, 1997b) primary subtest scores were evaluated in a sample of patients with intractable temporal lobe epilepsy (N = 254). Models specifying separate immediate and delayed constructs resulted in inadmissible parameter estimates and model specification error. There were negligible goodness-of-fit differences between a 3-factor model of working memory, auditory memory, and visual memory and a nested--more parsimonious--2-factor model of working memory and general memory. The results suggest that specifying a separate visual memory factor provides little advantage for this sample--an unexpected finding in a population with lateralized dysfunction, for which one might have predicted separate auditory and visual memory dimensions.     

Visual perspective taking for avatars in a Simon task

In modern digital applications, users often interact with virtual representations of themselves or others, called avatars. We examined how these avatars and their perspectives influence stimulus–response compatibility in a Simon task. Participants responded to light/dark blue stimuli with left/right key presses in the presence of a task-irrelevant avatar. Changes in stimulus–response compatibility were used to quantify changes in the mental representation of the task and perspective taking toward this avatar. Experiments 1 and 2 showed that perspective taking for an avatar occurred in orthogonal stimulus–response mappings, causing a compatibility effect from the avatar’s point of view. In the following two experiments we introduced a larger variety of angular disparities between the participant and avatar. In Experiment 3, the Simon effect with lateralized stimulus positions remained largely unaffected by the avatar, pointing toward an absence of perspective taking. In Experiment 4, after avatar hand movements were added in order to strengthen the participants’ sense of agency over the avatar, a spatial compatibility effect from the avatar’s perspective was observed again, and hints of the selective use of perspective taking on a trial-by-trial basis were found. Overall, the results indicate that users can incorporate the perspective of an avatar into their mental representation of a situation, even when this perspective is unnecessary to complete a task, but that certain contextual requirements have to be met.