Cognitive and Behavioural Attention in Children with Low-Moderate and Heavy Doses of Prenatal Alcohol Exposure: a Systematic Review and Meta-analysis

Neuropsychology Review - Attention problems are thought to be a hallmark feature of prenatal alcohol exposure (PAE). Despite decades of research however, these findings have never been pooled to...     

Eudaimonia and well-being: questioning the moral authority of advance directives in dementia

Theoretical Medicine and Bioethics - This paper revisits Ronald Dworkin’s influential position that a person’s advance directive for future health care and medical treatment retains its...     

The relationship between acute stress disorder and posttraumatic stress disorder in severely injured trauma survivors

This prospective longitudinal study was designed to investigate the relationship between acute stress disorder (ASD) and the subsequent development of posttraumatic stress disorder (PTSD) in a population of severely injured hospitalised trauma survivors. Symptoms of ASD were assessed just prior to discharge in 307 consecutive admissions to a Level 1 Trauma Centre, with PTSD assessments completed at 3 and 12 months post-injury. A well-established structured clinical interview was adopted for both assessments. Only 1% of the sample met criteria for an ASD diagnosis (at a mean of 8 days post-injury), while the incidence of PTSD was 9% at 3 months and 10% at 12 months. Although all ASD symptom clusters contributed to the prediction of subsequent PTSD severity, logistic regression indicated that only re-experiencing and arousal predicted a categorical PTSD diagnosis. The dissociative symptoms that form the core of ASD were rarely endorsed and showed high specificity but low sensitivity, resulting in a high proportion of false negative diagnoses. Reducing the number of dissociative symptoms required for a diagnosis ameliorated, but did not resolve, the problem. In this particular population, the low sensitivity of the ASD diagnosis renders it a poor screening test for use in identifying high risk individuals for early intervention and prevention strategies.     

Hungry pigeons make suboptimal choices, less hungry pigeons do not

Hungry animals will often choose suboptimally by being attracted to reliable signals for food that occur infrequently (they gamble) over less reliable signals for food that occur more often. That is, pigeons prefer an option that 50?% of the time provides them with a reliable signal for the appearance of food but 50?% of the time provides them with a reliable signal for the absence of food (overall 50?% reinforcement) over an alternative that always provides them with a signal for the appearance of food 75?% of the time (overall 75?% reinforcement). The pigeons appear to choose impulsively for the possibility of obtaining the reliable signal for reinforcement. There is evidence that greater hunger is associated with greater impulsivity. We tested the hypothesis that if the pigeons were less hungry, they would be less impulsive and, thus, would choose more optimally (i.e., on the basis of the overall probability of reinforcement). We found that hungry pigeons choose the 50?% reinforcement alternative suboptimally but less hungry pigeons prefer the more optimal 75?% reinforcement. Paradoxically, pigeons that needed the food more received less of it. These findings have implications for how level of motivation may also affect human suboptimal choice (e.g., purchase of lottery tickets and playing slot machines).     

Rhetorics of Health Citizenship: Exploring Vernacular Critiques of Government’s Role in Supporting Healthy Living

This article explores how older adults negotiate and partially counter normative expectations of “health citizenship” that stress individual responsibility for maintaining health and preventing health problems. Based on interviews with 55 participants in Canada and the U.K. about what healthy living means to them in their everyday lives, we examine how the dominant discourse of personal responsibility in participants’ responses is counterpointed by a more muted, yet significant, alternative critical perspective on the relative roles and responsibilities of government and citizens in making healthy living possible. Drawing on Hauser’s (1999) concept of vernacular rhetoric along with recent theories of environmental citizenship, we analyze how participants exercise their civic-political judgment by using a logic of dissociation to argue that what government says about the importance of healthy living is incompatible with what government does to support citizens’ abilities to eat healthily and live actively. By deploying this technique of argumentation to address structural-political-economic dimensions of healthy living, participants enact, in modest ways, an alternative, critical-collective mode of health citizenship that complicates and, at least partially, disrupts neoliberal constructions of the individually responsible, “good” health citizen.     

The Role of Optimism,Social Constraints,Coping, and Cognitive Processing in Psychosocial Adjustment Among Breast Cancer Survivors

The social-cognitive processing model suggests that a socially constrained environment may impede adjustment to a chronic illness. The present study primarily investigated the mediating psychological pathways through which social constraints on cancer-related disclosure, low optimism, disengagement-oriented coping, and brooding could be associated with low levels of psychosocial adjustment. One hundred twenty-five female breast cancer survivors participated in a cross-sectional study. Path analysis was used to examine the proposed model. Low optimism, increased social constraints, and higher levels of brooding appeared to be risk factors for poor psychosocial adjustment to breast cancer. Disengagement-oriented coping and brooding partially mediated the relationship between social constraints and adjustment. Brooding totally mediated the relationship between disengagement-oriented coping and adjustment. The current findings provide support for the value of the social-cognitive processing model among breast cancer survivors. The mapping of psychological pathways of adjustment to breast cancer may have useful clinical implications for better adjustment outcomes.     

Outliers and Influential Observations in Exponential Random Graph Models

We discuss measuring and detecting influential observations and outliers in the context of exponential family random graph (ERG) models for social networks. We focus on the level of the nodes of the network and consider those nodes whose removal would result in changes to the model as extreme or “central” with respect to the structural features that “matter”. We construe removal in terms of two case-deletion strategies: the tie-variables of an actor are assumed to be unobserved, or the node is removed resulting in the induced subgraph. We define the difference in inferred model resulting from case deletion from the perspective of information theory and difference in estimates, in both the natural and mean-value parameterisation, representing varying degrees of approximation. We arrive at several measures of influence and propose the use of two that do not require refitting of the model and lend themselves to routine application in the ERGM fitting procedure. MCMC p values are obtained for testing how extreme each node is with respect to the network structure. The influence measures are applied to two well-known data sets to illustrate the information they provide. From a network perspective, the proposed statistics offer an indication of which actors are most distinctive in the network structure, in terms of not abiding by the structural norms present across other actors.