Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better understood (...) as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)

Applying the framework proposed by Jeffery et al. to nonhuman primates moving in multilayer arboreal and terrestrial environments, we see that these animals must generate a mosaic of many bicoded spaces in order to move efficiently and safely through their habitat. Terrestrial light detection and ranging (LiDAR) technology and three-dimensional modelling of canopy movement may permit testing of Jeffery et al.'s framework in natural environments.

The ability to rapidly detect facial expressions of anger and threat over other salient expressions has adaptive value across the lifespan. Although studies have demonstrated this threat superiority effect in adults, surprisingly little research has examined the development of this process over the childhood period. In this study, we examined the efficiency of children's facial processing in visual search tasks. In Experiment 1, children (N=49) aged 8 to 11 years were faster and more accurate in detecting angry target faces embedded (...) in neutral backgrounds than vice versa, and they were slower in detecting the absence of a discrepant face among angry than among neutral faces. This search pattern was unaffected by an increase in matrix size. Faster detection of angry than neutral deviants may reflect that angry faces stand out more among neutral faces than vice versa, or that detection of neutral faces is slowed by the presence of surrounding angry distracters. When keeping the background constant in Experiment 2, children (N=35) aged 8 to 11 years were faster and more accurate in detecting angry than sad or happy target faces among neutral background faces. Moreover, children with higher levels of anxiety were quicker to find both angry and sad faces whereas low anxious children showed an advantage for angry faces only. Results suggest a threat superiority effect in processing facial expressions in young children as in adults and that increased sensitivity for negative faces may be characteristic of children with anxiety problems. (shrink)

ABSTRACTThe attentional blink is the impaired ability to detect a second target when it follows shortly after the first among distractors in a rapid serial visual presentation...

There is convincing evidence of the transmission of anxiety and depression from parents to children; however, mechanisms by which this vulnerability is passed on are unclear. Cognitive models and a small body of cross-sectional research suggest that parental attention biases may be one mechanism involved in transmission. Longitudinal associations of maternal and offspring ABs with offspring symptoms have been scarcely studied. Forty-three mothers–child dyads were included. All children were diagnosis-free while 24 mothers had a lifetime emotional disorder and 19 mothers (...) had no psychiatric diagnoses. This study examined cross-sectional and longitudinal associations of maternal and child AB and child anxiety symptomology at initial and 12-month assessments. ABs were assessed using a visual-probe task with emotional faces. There was a significant cross-sectional but not longitudinal association of increased child anxiety symptoms with increased maternal threat AB for HR but not LR dyads. At the cross-sectional level, increases in HR but not LR offspring anxiety symptomology were associated with maternal threat AB. Larger longitudinal studies are required that examine the interplay between parent–child variables and include multiple time-points of assessment and measures of AB. (shrink)

This article examines the rise of the anti-vaccination movement, the proliferation of laws allowing parental exemptions to mandatory school vaccines, and the impact of the movement on immunization rates for all vaccines. It uses the ongoing debate about the Human Papillomavirus vaccine as an example to highlight the ripple effect and consequences of the anti-vaccine movement despite robust evidence of the vaccine's safety and efficacy. The article scrutinizes how state legislatures ironically promote vaccination while simultaneously deferring to the opposition by (...) promulgating broad opt-outs from mandatory vaccine laws. This article concludes by offering an alternative legislative approach to specifically combat the anti-vaccine movement's impact on HPV vaccination rates. Lowering the age of consent has not been widely attempted or proposed and provides an alternative statutory mechanism to push back against vaccine resistance. (shrink)

The subject of this thesis is Friedrich Nietzsche’s methodology, the genealogical mode of inquiry, which came to fruition in On the Genealogy of Morals. The precise nature of the genealogy, as a mode of inquiry, is a site of contest amongst scholars, with the central debates pivoting around four questions which arise upon considering the methodology: what is the critical import of Nietzsche’s genealogical mode of inquiry? What form of critique does it take? To whom does Nietzsche address his reflections? (...) And what role, if any, does history play in Nietzsche’s genealogical narratives? Accordingly, this thesis seeks to offer and to defend answers to the central questions that are generated by the consideration of Nietzsche’s methodology. In order to get a foothold into these debates and to provide the boundary within which these disagreements occur the first chapter has as its object of inquiry an examination and evaluation of Nietzsche scholars’ responses to these issues. In chapter two I defend my interpretation against these rival views, and contend that the genealogy takes the form of an immanent critique, and that it is intended, at least, to reach all of Nietzsche’s contemporaries. The adage “genealogy is history correctly practiced” is treated in the remaining three chapters, in which I attempt to morph what appears to be at present an uninformative formulation into an informative one by arguing that for Nietzsche historiography is best seen as a form of artistry. And, this I submit, serves to shed light upon the genealogical mode of inquiry, and to shape the boundary by which the equation of genealogy as methodology with history becomes instructive. (shrink)

This paper has both theoretical and practical ambitions. The theoretical ambitions are to explore what would constitute both effective and ethical treatment of Autism Spectrum Disorder.1 However, the practical ambition is perhaps more important: we argue that a dominant form of Applied Behavior Analysis, which is widely taken to be far-and-away the best “treatment”2 for ASD, manifests systematic violations of the fundamental tenets of bioethics. Moreover, the supposed benefits of the treatment not only fail to mitigate these violations, but they (...) often exacerbate them. Warnings of the perils of ABA are not original to us—autism advocates have been ringing this... (shrink)

Success in online and blended courses requires engaging in self-regulated learning, especially for challenging STEM disciplines, such as physics. This involves students planning how they will navigate course assignments and activities, setting goals for completion, monitoring their progress and content understanding, and reflecting on how they completed each assignment. Based on Winne & Hadwin’s COPES model, SRL is a series of events that temporally unfold during learning, impacted by changing internal and external factors, such as goal orientation and content difficulty. (...) Thus, as goal orientation and content difficulty change throughout a course, so might students’ use of SRL processes. This paper studies how students’ SRL behavior and achievement goal orientation change over time in a large college introductory level physics course taught online. Students’ achievement goal orientation was measured by repeated administration of the achievement goals questionnaire-revised. Students’ SRL behavior was measured by analyzing their clickstream event traces interacting with online learning modules via a combination of trace clustering and process mining. Event traces were first divided into groups similar in nature using agglomerative clustering, with similarity between traces determined based on a set of derived characteristics most reflective of students’ SRL processes. We then generated causal nets for each cluster of traces via process mining and interpreted the underlying behavior and strategy of each causal net according to the COPES SRL framework. We then measured the frequency at which students adopted each causal net and assessed whether the adoption of different causal nets was associated with responses to the AGQ-R. By repeating the analysis for three sets of online learning modules assigned at the beginning, middle, and end of the semester, we examined how the frequency of each causal net changed over time, and how the change correlated with changes to the AGQ-R responses. Results have implications for measuring the temporal nature of SRL during online learning, as well as the factors impacting the use of SRL processes in an online physics course. Results also provide guidance for developing online instructional materials that foster effective SRL for students with different motivational profiles. (shrink)

In humans over 15% of X‐linked genes have been shown to ‘escape’ from X‐chromosome inactivation (XCI): they continue to be expressed to some extent from the inactive X chromosome. Mono‐allelic expression is anticipated within a cell for genes subject to XCI, but random XCI usually results in expression of both alleles in a cell population. Using a study of allelic expression from cultured lymphoblasts and fibroblasts, many of which showed substantial skewing of XCI, we recently reported that the expression of (...) genes lies on a contiunuum between those that are subject to inactivation, and those that escape. We now review allelic expression studies from mouse, and discuss the variability in escape seen in both humans and mice in genic expression levels, between X chromosomes and between tissues. We also discuss current knowledge of the heterochromatic features, DNA elements and three‐dimensional topology of the inactive X that contribute to the balance of expression from the otherwise inactive X chromosome. (shrink)

Purpose: to characterize ethics course content, structure, resources, pedagogic methods, and opinions among academic administrators and course directors at U.S. medical schools. Method: An online questionnaire addressed to academic deans and ethics course directors identified by medical school websites was emailed to 157 Association of American Medical Colleges member medical schools in two successive waves in early 2022. Descriptive statistics were utilized to summarize responses. Results: Representatives from 61 (39%) schools responded. Thirty-two (52%) respondents were course directors; 26 (43%) were (...) deans of academic affairs, medical education, or curriculum; and 3 with other roles also completed the survey (5%). All 61 schools reported some form of formal ethics education during the first year of medical school, with most (n = 54, 89%) reporting a formal mandatory introductory course during preclinical education. Schools primarily utilized lecture and small-group teaching methods. Knowledge-based examinations, attendance, and participation were most commonly used for assessment. A large majority regarded ethics as equally or more important than other foundational courses, but fewer (n = 37, 60%) provided faculty training for teaching ethics. Conclusions: Despite a response rate of 39 percent, the authors conclude that medical schools include ethics in their curricula in small-group and lecture formats with heterogeneity regarding content taught. Preclinical curricular redesigns must innovate and implement best practices for ensuring sound delivery of ethics content in future curricula. Additional large-scale research is necessary to determine said best practices. (shrink)

Shared decision-making has become a new focus of health policy. Though its core elements are largely agreed upon, there is little consensus regarding which outcomes to prioritize for policy-mandated shared decision-making.

Across languages, children map words to meaning with great efficiency, despite a seemingly unconstrained space of potential mappings. The literature on how children do this is primarily limited to spoken language. This leaves a gap in our understanding of sign language acquisition, because several of the hypothesized mechanisms that children use are visual (e.g., visual attention to the referent), and sign languages are perceived in the visual modality. Here, we used the Human Simulation Paradigm in American Sign Language (ASL) to (...) determine potential cues to word learning. Sign‐naïve adult participants viewed video clips of parent–child interactions in ASL, and at a designated point, had to guess what ASL sign the parent produced. Across two studies, we demonstrate that referential clarity in ASL interactions is characterized by access to information about word class and referent presence (for verbs), similarly to spoken language. Unlike spoken language, iconicity is a cue to word meaning in ASL, although this is not always a fruitful cue. We also present evidence that verbs are highlighted well in the input, relative to spoken English. The results shed light on both similarities and differences in the information that learners may have access to in acquiring signed versus spoken languages. (shrink)

In spring 2020, COVID-19 and the ensuing social distancing and stay-at-home orders instigated abrupt changes to employment and educational infrastructure, leading to uncertainty, concern, and stress among United States college students. The media consumption patterns of this and other social groups across the globe were affected, with early evidence suggesting viewers were seeking both pandemic-themed media and reassuring, familiar content. A general increase in media consumption, and increased consumption of specific types of content, may have been due to media use (...) for coping strategies. This paper examines the relationship between the stress and anxiety of university students and their strategic use of media for coping during initial social distancing periods in March-April 2020 using data from a cross-sectional survey. We examine links between specific types of media use with psychological well-being concepts, and examine the moderating roles of traits as buffers against negative relationships between stress and anxiety and psychological well-being. Our findings indicate that stress was linked to more hedonic and less eudaimonic media use, as well as more avoidant and escapist media-based coping. Anxiety, on the other hand, was linked to more media use in general, specifically more eudaimonic media use and a full range of media-based coping strategies. In turn, escapist media was linked to negative affect, while reframing media and eudaimonic media were linked to positive affect. Avoidant coping was tied to poorer mental health, and humor coping was tied to better mental health. Hedonic and need-satisfying media use were linked to more flourishing. Hope, optimism, and resilience were all predictive of media use, with the latter two traits moderating responses to stress and anxiety. The findings give a nuanced portrait of college students’ media use during a pandemic-induced shutdown, showing that media use is closely intertwined with well-being in both adaptive and maladaptive patterns. (shrink)

For William James, work was the problem. Ultimately, going to work was the resolution, and James's quest for meaningful work remains as relevant at the end of the twentieth century as it was in the nineteenth. Weaving letters, diaries, drawings, and published texts, Becoming William James provides a convincing biographical analysis rich in detail and tone. In his new introduction, Howard M. Feinstein adds biological psychiatry to psychoanalytic and family systems theories to inform our understanding of a complex man. (...) In addition, he discusses whether James's mental illness might have been treated with drugs. (shrink)