Found 11226 matches for
Conceptualization of moral injury: A socio-cognitive perspective
As research into moral injury (MI) develops, a clearer conceptualization is needed to support further research and development of treatments. Tis article draws on the existing MI literature and proposes a new model for its conceptualization. Te authors propose that central to MI is deterioration in the relationship with self, others, and humanity, leading to global belief and behavioural changes. A defnition of what is, and is not, a potentially morally injurious event (PMIE) is also presented, and the authors argue that events need to be high stakes and threaten previously held beliefs, regardless of the event’s outcome. Te model highlights key predisposing factors that may infuence the later development and maintenance of MI, such as adverse childhood experiences and factors surrounding the event. By considering what distinguishes PMIEs from Diagnostic and Statistical Manual of Mental Disorders (5th ed.) posttraumatic stress disorder criterion A events and what factors may lead to MI, a better understanding of MI development and treatment can be considered.
Identifying Child Anxiety Through Schools-identification to intervention (iCATS-i2i): protocol for single-arm feasibility trial.
BACKGROUND: Anxiety disorders are common among primary-school aged children, but few affected children receive evidence-based treatment. Identifying and supporting children who experience anxiety problems through schools would address substantial treatment access barriers that families and school staff often face. We have worked with families and school staff to co-design procedures that incorporate screening, feedback for parents, and the offer of a brief intervention in primary schools. This study sets out to assess the feasibility of a subsequent school-based cluster randomised controlled trial to evaluate these procedures. Our objectives are to ensure our procedures for identifying and supporting children with anxiety difficulties through primary schools are acceptable and there are no negative impacts, to estimate recruitment and retention rates, and to identify any changes needed to study procedures or measures. METHODS: We will recruit six primary/junior schools in England (2 classes per school), and invite all children (aged 8-9) (n = 360) and their parent/carer and class teacher in participating classes to take part. Children, parents and class teachers will complete questionnaires at baseline and 12-week follow-up. Children who 'screen positive' on a 2-item parent-report child anxiety screen at baseline will be the target population (expected n = 43). Parents receive feedback on screening questionnaire responses, and where the child screens positive the family is offered support (OSI: Online Support and Intervention for child anxiety). OSI is a brief, parent-led online intervention, supported by short telephone sessions with a Children's Wellbeing Practitioner. Participants' experiences of study procedures will be assessed through qualitative interviews/discussion groups. DISCUSSION: Evidence-based procedures for identifying and supporting children with anxiety difficulties through primary schools would improve children's access to timely, effective intervention for anxiety difficulties. TRIAL REGISTRATION: ISRCTN registry: ISRCTN30032471 . Retrospectively registered on 18 May 2021.
Identifying Child Anxiety Through Schools-identification to intervention (iCATS-i2i): protocol for a cluster randomised controlled trial to compare screening, feedback and intervention for child anxiety problems to usual school practice.
BACKGROUND: Systematically screening for child anxiety problems, and offering and delivering a brief, evidence-based intervention for children who are identified as likely to benefit would minimise common barriers that families experience in accessing treatment. We have developed a short parent-report child anxiety screening questionnaire, and procedures for administering screening questionnaires, sharing screening outcomes with families, and offering and delivering a brief parent-led online intervention (OSI: Online Support and Intervention for child anxiety) through schools. This trial aims to evaluate clinical and health economic outcomes for (1) children (aged 8-9) who screen positive for anxiety problems at baseline (target population) and (2) the wider population of all children in participating classes (total population) in schools randomly allocated to receive identification-to-intervention procedures and usual school practice ('screening and intervention'), compared to assessment and usual school practice only ('usual school practice'). METHODS: The trial design is a parallel-group, superiority cluster randomised controlled trial, with schools (clusters) randomised to 'screening and intervention' or 'usual school practice' arms in a 1:1 ratio stratified according to the level of deprivation within the school. We will recruit schools and participants in two phases (a pilot phase (Phase 1) and Phase 2), with progression criteria assessed prior to progressing to Phase 2. In total, the trial will recruit 80 primary/junior schools in England, and 398 children (199 per arm) who screen positive for anxiety problems at baseline (target population). In schools allocated to 'screening and intervention': (1) parents/carers will complete a brief parent-report child anxiety screening questionnaire (at baseline) and receive feedback on their child's screening outcomes (after randomisation), (2) classes will receive a lesson on managing fears and worries and staff will be provided with information about the intervention and (3) parents/carers of children who screen positive for anxiety problems (target population) will be offered OSI. OSI will also be available for any other parents/carers of children in participating classes (total population) who request it. We will collect child-, parent- and teacher-report measures for the target population and total population at baseline (before randomisation), 4 months, 12 months and 24 months post-randomisation. The primary outcome will be the proportion of children who screen positive for anxiety problems at baseline (target population) who screen negative for anxiety problems 12 months post-randomisation. DISCUSSION: This trial will establish if systematic screening for child anxiety problems, sharing screening outcomes with families and delivering a brief parent-led online intervention through schools is effective and cost-effective. TRIAL REGISTRATION: ISRCTN registry ISRCTN76119074. Prospectively registered on 4.1.2022.
Parents' experiences of parenting a preadolescent children with obsessive compulsive disorder (OCD): a qualitative study
ABSTRACT Obsessive Compulsive Disorder (OCD) has negative impacts on affected preadolescent children; however, little is known about parents’ experiences of parenting a preadolescent child with OCD, and limited provision exists to help parents to support their children. This study aimed to explore parents’ experiences of parenting a preadolescent child with OCD using semi-structured, qualitative interviews to inform the development of such provision. Twenty-two parents (15 mothers; 7 fathers) of 16 children (7- to 14-years-old) who had experienced OCD were interviewed. Reflexive thematic analysis was used to generate two overarching themes: (1) challenge and frustration, and (2) helplessness, and five themes: (1) the journey to understanding and coming to terms with OCD, (2) the battle for support, (3) navigating how to respond to OCD, (4) OCD is in control, and (5) the emotional turmoil of parenting a preadolescent child with OCD. The need for clear, accessible, and scalable support for parents of preadolescent children with OCD was identified.
Swearing as a response to pain: A cross-cultural comparison of British and Japanese participants.
BACKGROUND AND AIMS: Research suggests swearing can moderate pain perception. The present study assessed whether changes in pain perception due to swearing reflect a "scripting" effect by comparing swearing as a response to pain in native English and Japanese speakers. Cognitive psychology denotes a 'script' to be a sequence of learnt behaviours expected for given situations. Japanese participants were included as they rarely, if ever, swear as a response to pain and therefore do not possess an available script for swearing in the context of pain. It was hypothesised that Japanese participants would demonstrate less tolerance and more sensitivity to pain than English participants, and - due to a lack of an available script of swearing in response to pain - that Japanese participants would not experience swearword mediated hypoalgesia. METHODS: Fifty-six native English (mean age=23 years) and 39 Japanese (mean age=21) speakers completed a cold-pressor task whilst repeating either a swear on control word. A 2 (culture; Japanese, British)×2 (word; swear; non-swear) design explored whether Japanese participants showed the same increase in pain tolerance and experienced similar levels of perceived pain when a swearing intervention was used as British participants. Pain tolerance was assessed by the number of seconds participants could endure of cold-pressor exposure and self-report pain measurements. Levels of perceived pain were assessed using a 120-mm horizontal visual analogue scale anchored by descriptors in the participant's native language of "no pain" (left) and "terrible pain" (right). The participant was asked to mark a 10mm vertical line to indicate overall pain intensity. The score was measured from the zero anchor to the participant's mark. RESULTS: Japanese participants reported higher levels of pain (p<0.005) and displayed lower pain tolerance than British participants (p<0.05). Pain tolerance increased in swearers regardless of cultural background (p<0.001) and no interaction was found between word group and culture (p=0.96), thereby suggesting that swearing had no differential effect related to the cultural group of the participant. CONCLUSIONS: The results replicate previous findings that swearing increases pain tolerance and that individuals from an Asian ethnic background experience greater levels of perceived pain than those from a Caucasian ethnic background. However, these results do not support the idea of pain perception modification due to a "scripting" effect. This is evidenced as swearword mediated hypoalgesia occurs irrespective of participant cultural background. Rather, it is suggested that modulation of pain perception may occur through activation of descending inhibitory neural pain mechanisms. IMPLICATIONS: As swearing can increase pain tolerance in both Japanese and British people, it may be suggested that swearword mediated hypoalgesia is a universal phenomenon that transcends socio-cultural learnt behaviours. Furthermore, swearing could be encouraged as an intervention to help people cope with acute painful stimuli.
Primary school-based screening for childhood mental health problems and intervention delivery: a qualitative study of parents in challenging circumstances
Few children with mental health problems access evidence-based interventions. Primary schools may be an ideal setting to improve access to treatment through screening and intervention programmes, but some families’ circumstances and experiences may increase barriers to benefiting from this approach. Interviews were carried out with parents of children living in potentially challenging circumstances, including foster and military-connected families. We aimed to explore parent perceptions of a school-based screening/intervention programme and potential barriers to uptake. Parents described that due to their past experiences, that they might not trust or engage with a school-based screening/intervention. Nonetheless, parents considered that the delivery of a sensitive school screening/intervention programme might provide an opportunity for schools to strengthen their relationship with families. These findings highlight the need for future school-based screening/intervention programmes for child mental health to consider the needs of families of children from varied circumstances, and ensure steps are taken to promote trust.
Teaching open and reproducible scholarship: a critical review of the evidence base for current pedagogical methods and their outcomes.
In recent years, the scientific community has called for improvements in the credibility, robustness and reproducibility of research, characterized by increased interest and promotion of open and transparent research practices. While progress has been positive, there is a lack of consideration about how this approach can be embedded into undergraduate and postgraduate research training. Specifically, a critical overview of the literature which investigates how integrating open and reproducible science may influence student outcomes is needed. In this paper, we provide the first critical review of literature surrounding the integration of open and reproducible scholarship into teaching and learning and its associated outcomes in students. Our review highlighted how embedding open and reproducible scholarship appears to be associated with (i) students' scientific literacies (i.e. students' understanding of open research, consumption of science and the development of transferable skills); (ii) student engagement (i.e. motivation and engagement with learning, collaboration and engagement in open research) and (iii) students' attitudes towards science (i.e. trust in science and confidence in research findings). However, our review also identified a need for more robust and rigorous methods within pedagogical research, including more interventional and experimental evaluations of teaching practice. We discuss implications for teaching and learning scholarship.
The stability of transient relationships.
In contrast to long-term relationships, far less is known about the temporal evolution of transient relationships, although these constitute a substantial fraction of people's communication networks. Previous literature suggests that ratings of relationship emotional intensity decay gradually until the relationship ends. Using mobile phone data from three countries (US, UK, and Italy), we demonstrate that the volume of communication between ego and its transient alters does not display such a systematic decay, instead showing a lack of any dominant trends. This means that the communication volume of egos to groups of similar transient alters is stable. We show that alters with longer lifetimes in ego's network receive more calls, with the lifetime of the relationship being predictable from call volume within the first few weeks of first contact. This is observed across all three countries, which include samples of egos at different life stages. The relation between early call volume and lifetime is consistent with the suggestion that individuals initially engage with a new alter so as to evaluate their potential as a tie in terms of homophily.
Normality and the Treatment-Enhancement Distinction
There is little debate regarding the acceptability of providing medical care to restore physical or mental health that has deteriorated below what is considered typical due to disease or disorder (i.e., providing “treatment”—for example, administering psychostimulant medication to sustain attention in the case of attention deficit disorder). When asked whether a healthy individual may undergo the same intervention for the purpose of enhancing their capacities (i.e., “enhancement”—for example, use of a psychostimulant as a “study drug”), people often express greater hesitation. Building on prior research in moral philosophy and cognitive science, in this work, we ask why people draw a moral distinction between treatment and enhancement. In two experiments, we provide evidence that the accessibility of health-related interventions determines their perceived descriptive or statistical normality (Experiment 1), and that gains in descriptive normality for such interventions weaken the moral distinction between treatment and enhancement (Experiment 2). In short, our findings suggest that the tendency to draw a moral distinction between treatment and enhancement is driven, in part, by assumptions about descriptive abnormality; and raise the possibility that normalizing novel biomedical interventions by promoting access could undermine people’s selective opposition toward enhancement, rendering it morally comparable to treatment.
Genital Autonomy and Sexual Well-being
Purpose of Review: The purpose of this study is to survey recent arguments in favor of preserving the genital autonomy of children—female, male, and intersex—by protecting them from medically unnecessary genital cutting practices. Recent Findings: Nontherapeutic female, male, and intersex genital cutting practices each fall on a wide spectrum, with far more in common than is generally understood. When looking across cultures and comparing like cases, one finds physical, psychosexual, and symbolic overlaps among the three types of cutting, suggesting that a shared ethical framework is needed. Summary: All children have an interest in genital autonomy, regardless of their sex or gender.
Bright-light distractions and visual performance
Visual distractions pose a significant risk to transportation safety, with laser attacks against aircraft pilots being a common example. This study used a research-grade High Dynamic Range (HDR) display to produce bright-light distractions for 12 volunteer participants performing a combined visual task across central and peripheral visual fields. The visual scene had an average luminance of 10 cd∙m−2 with targets of approximately 0.5° angular size, while the distractions had a maximum luminance of 9,000 cd∙m−2 and were 3.6° in size. The dependent variables were the mean fixation duration during task execution (representative of information processing time), and the critical stimulus duration required to support a target level of performance (representative of task efficiency). The experiment found a statistically significant increase in mean fixation duration, rising from 192 ms without distractions to 205 ms with bright-light distractions (p = 0.023). This indicates a decrease in visibility of the low contrast targets or an increase in cognitive workload that required greater processing time for each fixation in the presence of the bright-light distractions. Mean critical stimulus duration was not significantly affected by the distraction conditions used in this study. Future experiments are suggested to replicate driving and/or piloting tasks and employ bright-light distractions based on real-world data, and we advocate the use of eye-tracking metrics as sensitive measures of changes in performance.
Correction to: Broad Medical Uncertainty and the ethical obligation for openness (Synthese, (2022), 200, 2, (121), 10.1007/s11229-022-03666-2)
The original article has been corrected. During proof correction, a mistake was introduced by Springer Nature in section 2.2.1.