Network Alterations in Comorbid Chronic Pain and Opioid Addiction: An Exploratory Approach.Rachel F. Smallwood,Larry R. Price,Jenna L. Campbell,Amy S. Garrett,Sebastian W. Atalla,Todd B. Monroe,Semra A. Aytur,Jennifer S.Potter &Donald A. Robin -2019 -Frontiers in Human Neuroscience 13:448994.detailsThe comorbidity of chronic pain and opioid addiction is a serious problem that has been growing with the practice of prescribing opioids for chronic pain. Neuroimaging research has shown that chronic pain and opioid dependence both affect brain structure and function, but this is the first study to evaluate the neurophysiological alterations in patients with comorbid chronic pain and addiction. Eighteen participants with chronic low back pain and opioid addiction were compared with eighteen age- and sex-matched healthy individuals in a (...) pain-induction fMRI task. Unified structural equation modeling (SEM) with Lagrange multiplier (LM) testing yielded a network model of pain processing for patient and control groups based on 19 a priori defined regions. Tests of differences between groups on specific regression parameters were determined on a path-by-path basis using z-tests corrected for the number of comparisons. Patients with the chronic pain and addiction comorbidity had increased connection strengths; many of these connections were interhemispheric and spanned regions involved in sensory, affective, and cognitive processes. The affected regions included those that are commonly altered in chronic pain or addiction alone, indicating that this comorbidity manifests with neurological symptoms of both disorders. Understanding the neural mechanisms involved in the comorbidity is crucial to finding a comprehensive treatment, rather than treating the symptoms individually. (shrink)
From Hinge Narrative to Habit: Self-Oriented Narrative Psychotherapy Meets Feminist Phenomenological Theories of Embodiment.Jennifer Hansen -2013 -Philosophy, Psychiatry, and Psychology 20 (1):69-73.detailsIn what follows, I offer some friendly amendments toPotter’s psychotherapeutic model—‘the hinge narrative’ (HN)—designed to help bipolar patients cultivate self-trust. My primary contribution is to suggest an alliance between narrative theory and feminist phenomenological theories of embodiment. I argue that these projects are mutually supporting in both the metaphysical and therapeutic project of constituting a rich moral self, that is, a self who has self-trust and thereby satisfying relationships with others. I also register a slight disagreement with (...) class='Hi'>Potter concerning the effect that bipolar illness has on agency.Potter claims that with conventional narratives patients have difficulty perceiving .. (shrink)
When Public Health and Genetic Privacy Collide: Positive and Normative Theories Explaining How ACA's Expansion of Corporate Wellness Programs Conflicts with GINA's Privacy Rules.Jennifer S. Bard -2011 -Journal of Law, Medicine and Ethics 39 (3):469-487.detailsThe passing of the Patient Protection and Affordable Care Act is a triumph for the field of public health. Its inclusion of many provisions intended to prevent illness and promote health endorses the core belief of public health as expressed by Dr. Georges Benjamin, the long-time executive director of the American Public Health Association, in a Washington Post opinion piece praising ACA for “provid[ing] care as far upstream as possible… [in order to] reduce costs by identifying problems early and then (...) managing them to reduce or eliminate the need for more costly care in the future.” In this article, I consider the conflict between ACA’s adoption of public health goals seeing population health and societal interests in protecting individuals from discrimination based on their health. The article focuses on one aspect of ACA which seeks to lower the costs to employers who provide health insurance for their employees by making it easier for them to offer their employees substantial incentives for participating in and meeting the goals of employer-sponsored Wellness Programs. (shrink)
Narratives of Participation in Autism Genetics Research.Jennifer S. Singh -2015 -Science, Technology, and Human Values 40 (2):227-249.detailsThis article provides empirical evidence of the social context and moral reasoning embedded within a parents’ decision to participate in autism genetics research. Based on in-depth interviews of parents who donated their family’s blood and medical information to an autism genetic database, three narratives of participation are analyzed, including the altruistic parent, the obligated parent, and the diagnostic parent. Although parents in this study were not generally concerned with bioethical principles such as autonomy and the issues of informed consent and/or (...) privacy and confidentiality of genetic information, a critical analysis reveals contextual bioethics embedded within these different narratives. These include the negotiations of responsibility that parents confront in biomedical research, the misguided hope and expectations parents place in genomic science, and the structural barriers of obtaining an autism diagnosis and educational services. Based on these findings, this article demonstrates the limits of a principle-based approach to bioethics and the emergent forms of biological citizenship that takes into account the social situations of people’s lives and the moral reasoning they negotiate when participating in autism genetic research. (shrink)
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Pregnancy Accompanied by Palliative Care.Jennifer S. Linebarger -2020 -Perspectives in Biology and Medicine 63 (3):535-538.detailsA woman, perhaps a couple, learn they are pregnant. Perhaps she is elated for this desired news. Perhaps she is also overwhelmed or scared by the daunting task of parenthood ahead. Then, a prenatal screening reveals something worrisome about the fetus. A tumbling series of appointments and exams confirm the concerning findings. As Pope Francis notes, this news “changes the experience of pregnancy.” In place of optimistic wonderment for the future, parents now have new worries about whether their baby will (...) have a shortened life, experience suffering, or face many medical interventions in order to survive. I am a pediatric and perinatal palliative care doctor. I am often called to meet these wounded yet resilient... (shrink)
Lack of Political Will and Public Trust Dooms Presumed Consent.Jennifer S. Bard -2012 -American Journal of Bioethics 12 (2):44-46.detailsThe American Journal of Bioethics, Volume 12, Issue 2, Page 44-46, February 2012.
Would Research Ethics Survive the Defunding of the Research University?Jennifer S. Bard -2014 -Hastings Center Report 44 (1):11-12.detailsThe future of biomedical and scientific research in the United States is inextricably attached to the universities and academic medical centers funded by the government. And the work many of us do commenting on ethical issues arising from that funded research is dependent on its continuation. Yet the institutions of higher education and the academic medical centers where this federally funded research takes place are under attack on many fronts. What would the world look like without federally supported research universities? (...) It is likely that the number of institutions doing funded research would drop dramatically, perhaps to the one hundred or so institutions that already receive the vast majority of funding. (shrink)
Current Emotion Research in Social Neuroscience: How does emotion influence social cognition?Jennifer S. Beer -2017 -Emotion Review 9 (2):172-180.detailsNeuroscience investigations of emotional influences on social cognition have been dominated by the somatic marker hypothesis and dual-process theories. Taken together, these lines of inquiry have not provided strong evidence that emotional influences on social cognition rely on neural systems which code for bodily signals of arousal nor distinguish emotional reasoning from other modes of reasoning. Recent findings raise the possibility that emotionally influenced social cognition relies on two stages of neural changes: once when emotion is elicited and a different (...) set of changes at the time of social cognitive judgment. These findings suggest that affect infusion models may be a fruitful framework for bridging neuroscience and psychological understanding of the role of emotion in social cognition. (shrink)
The Generalized Quantum Episodic Memory Model.Jennifer S. Trueblood &Pernille Hemmer -2017 -Cognitive Science:2089-2125.detailsRecent evidence suggests that experienced events are often mapped to too many episodic states, including those that are logically or experimentally incompatible with one another. For example, episodic over-distribution patterns show that the probability of accepting an item under different mutually exclusive conditions violates the disjunction rule. A related example, called subadditivity, occurs when the probability of accepting an item under mutually exclusive and exhaustive instruction conditions sums to a number >1. Both the over-distribution effect and subadditivity have been widely (...) observed in item and source-memory paradigms. These phenomena are difficult to explain using standard memory frameworks, such as signal-detection theory. A dual-trace model called the over-distribution model can explain the episodic over-distribution effect, but not subadditivity. Our goal is to develop a model that can explain both effects. In this paper, we propose the Generalized Quantum Episodic Memory model, which extends the Quantum Episodic Memory model developed by Brainerd, Wang, and Reyna. We test GQEM by comparing it to the OD model using data from a novel item-memory experiment and a previously published source-memory experiment examining the over-distribution effect. Using the best-fit parameters from the over-distribution experiments, we conclude by showing that the GQEM model can also account for subadditivity. Overall these results add to a growing body of evidence suggesting that quantum probability theory is a valuable tool in modeling recognition memory. (shrink)
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Parental Influence on Eating Behavior: Conception to Adolescence.Jennifer S. Savage,Jennifer Orlet Fisher &Leann L. Birch -2007 -Journal of Law, Medicine and Ethics 35 (1):22-34.detailsEating behaviors evolve during the first years of life as biological and behavioral processes directed towards meeting requirements for health and growth. For the vast majority of human history, food scarcity has constituted a major threat to survival, and human eating behavior and child feeding practices have evolved in response to this threat. Because infants are born into a wide variety of cultures and cuisines, they come equipped as young omnivores with a set of behavioral predispositions that allow them to (...) learn to accept the foods made available to them. During historical conditions of scarcity, family life and resources were devoted to the procurement and preparation of foods, which are often low in energy, nutrients, and palatability. In sharp contrast, today in non-Third World countries children's eating habits develop under unprecedented conditions of dietary abundance, where palatable, inexpensive, ready-to-eat foods are readily available. (shrink)
What’s the Point of Ceteris Paribus? or, How to Understand Supply and Demand Curves.Jennifer S. Jhun -2018 -Philosophy of Science 85 (2):271-292.detailsPhilosophers sometimes claim that economics, and the idealizing strategies it employs, is ultimately unable to provide genuine laws of nature. Therefore, unlike physics, it does not qualify as an actual science. Careful consideration of thermodynamics, a well-developed physical theory, reveals substantial parallels with economic methodology. The corrective account of scientific understanding I offer appreciates these parallels: understanding in terms of efficient performance.
Beyond valence: Toward a model of emotion-specific influences on judgement and choice.Jennifer S. Lerner &Dacher Keltner -2000 -Cognition and Emotion 14 (4):473-493.detailsMost theories of affective influences on judgement and choice take a valence-based approach, contrasting the effects of positive versus negative feeling states. These approaches have not specified if and when distinct emotions of the same valence have different effects on judgement. In this article, we propose a model of emotion-specific influences on judgement and choice. We posit that each emotion is defined by a tendency to perceive new events and objects in ways that are consistent with the original cognitive-appraisal dimensions (...) of the emotion. To pit the valence and appraisal-tendency approaches against one another, we present a study that addresses whether two emotions of the same valence but differing appraisals—anger and fear—relate in different ways to risk perception. Consistent with the appraisal-tendency hypothesis, fearful people made pessimistic judgements of future events whereas angry people made optimistic judgements. In the Discussion we expand the proposed model and review evidence supporting two social moderators of appraisal-tendency processes. (shrink)
A Quantum Probability Account of Order Effects in Inference.Jennifer S. Trueblood &Jerome R. Busemeyer -2011 -Cognitive Science 35 (8):1518-1552.detailsOrder of information plays a crucial role in the process of updating beliefs across time. In fact, the presence of order effects makes a classical or Bayesian approach to inference difficult. As a result, the existing models of inference, such as the belief-adjustment model, merely provide an ad hoc explanation for these effects. We postulate a quantum inference model for order effects based on the axiomatic principles of quantum probability theory. The quantum inference model explains order effects by transforming a (...) state vector with different sequences of operators for different orderings of information. We demonstrate this process by fitting the quantum model to data collected in a medical diagnostic task and a jury decision-making task. To further test the quantum inference model, a new jury decision-making experiment is developed. Using the results of this experiment, we compare the quantum inference model with two versions of the belief-adjustment model, the adding model and the averaging model. We show that both the quantum model and the adding model provide good fits to the data. To distinguish the quantum model from the adding model, we develop a new experiment involving extreme evidence. The results from this new experiment suggest that the adding model faces limitations when accounting for tasks involving extreme evidence, whereas the quantum inference model does not. Ultimately, we argue that the quantum model provides a more coherent account for order effects that was not possible before. (shrink)
(1 other version)Preschool Children's Mapping of Number Words to Nonsymbolic Numerosities.Jennifer S. Lipton &Elizabeth S. Spelke -unknowndetailsFive-year-old children categorized as skilled versus unskilled counters were given verbal estimation and number word comprehension tasks with numerosities 20 – 120. Skilled counters showed a linear relation between number words and nonsymbolic numerosities. Unskilled counters showed the same linear relation for smaller numbers to which they could count, but not for larger number words. Further tasks indicated that unskilled counters failed even to correctly order large number words differing by a 2 : 1 ratio, whereas they performed well on (...) this task with smaller numbers, and performed well on a nonsymbolic ordering task with the same numerosities. These findings provide evidence that large, approximate numerosity representations become linked to number words around the time that children learn to count to those words reliably. (shrink)
Exploitation and developing countries: The ethics of clinical research.Jennifer S. Hawkins &Ezekiel J. Emanuel -2008 - Princeton, NJ, USA: Princeton Univ Pr.detailsThis book was inspired originally by the debates at the turn of the century about placebo controlled trials of antiretrovirals in HIV positive pregnant women in developing countries. Moving forward from this one limited example, the book includes several additional controversial cases of clinical research conducted in developing countries, and asks probing philosophical questions about the ethics of such trials. All clinical research by its very nature uses people to acquire generalizable knowledge to help future people. But what sorts of (...) "use" are morally permissible? What is it to exploit people? Suppose that a trial conducted in a developing country would not be ethically permissible in the developed world. Can we automatically conclude from this that the trial is unethical, that some sort of morally problematic double standard is in operation? Or might the differences in the two settings justify differences in trial design? This collection of philosophical essays examines these important questions about what exploitation is and when clinical research counts as exploitative. -/- "This is an outstanding contribution to the growing literature on the ethics of research with human subjects and a fine example of what bioethics can offer at its best. Anyone with a serious interest in these issues will need to read this book from start to finish." -Daniel Wikler, Harvard School of Public Health "This book contributes significantly to the literature on exploitation in clinical research conducted in the developing world."--Patricia Marshall, Case Western Reserve University . (shrink)
Soldiers and Sailors in Aristophanes'Babylonians.Jennifer S. Starkey -2013 -Classical Quarterly 63 (2):501-510.detailsOnly two articles in the past century have attempted reconstructions of this play: Gilbert Norwood in 1930 conjectured a basis in tragic burlesque, specifically a parody of Aeschylus’Edoni, due largely to the presence of Dionysus and a chorus of Babylonians. An entirely different plot was proposed in 1983 by David Welsh, who took as his starting point Herodotus’ account of the fall of Babylon; he thought that the chorus, envisioned as a group of refugees from the Persian empire, reflected the (...) recent arrival in Athens of the grandson of the Persian primarily credited with the capture of Babylon. Though commentators on Aristophanic comedy and politics often affect to be on firm footing about this play, the total dissimilarity of these two reconstructions actually highlights our ignorance. (shrink)
The subjective intuition.Jennifer S. Hawkins -2010 -Philosophical Studies 148 (1):61 - 68.detailsTheories of well-being are typically divided into subjective and objective. Subjective theories are those which make facts about a person’s welfare depend on facts about her actual or hypothetical mental states. I am interested in what motivates this approach to the theory of welfare. The contemporary view is that subjectivism is devoted to honoring the evaluative perspective of the individual, but this is both a misleading account of the motivations behind subjectivism, and a vision that dooms subjective theories to failure. (...) I suggest that we need to revisit and reinstate certain features of traditional hedonism, in particular the idea that felt experience plays a role that no theory of welfare can afford to ignore. I then offer a sketch of a theory that is subjective in my preferred sense and avoids the worst sins of hedonism as well as the problems generated by the contemporary constraints of subjective theorists. (shrink)
Well-being, autonomy, and the horizon problem.Jennifer S. Hawkins -2008 -Utilitas 20 (2):143-168.detailsDesire satisfaction theorists and attitudinal-happiness theorists of well-being are committed to correcting the psychological attitudes upon which their theories are built. However, it is not often recognized that some of the attitudes in need of correction are evaluative attitudes. Moreover, it is hard to know how to correct for poor evaluative attitudes in ways that respect the traditional commitment to the authority of the individual subject's evaluative perspective. L. W. Sumner has proposed an autonomy-as-authenticity requirement to perform this task, but (...) this article argues that it cannot do the job. Sumner's proposal focuses on the social origins of our values and overlooks the deep psychological roots of other evaluative attitudes that are just as problematic for welfare. If subjective theories of welfare are to be at all plausible they may need to abandon or modify their traditional commitment to the authority of the individual subject. (shrink)
Multi-Model Reasoning in Economics: The Case of COMPASS.Jennifer S. Jhun -forthcoming -Philosophy of Science:1-28.detailsEconomists often consult multiple models in order to combat model uncertainty in the face of misspecification. By examining modeling practices at the Bank of England, this paper identifies an important, but underappreciated modeling procedure. Sometimes an idealized model is manipulated to reproduce the results from another distinct auxiliary model, ones which it could not produce on its own. However, this procedure does not involve making the original model “more realistic,” insofar as this means adding in additional causal factors. This suggests (...) that there are ways to make models more representationally adequate that do not involve de-idealization in the straightforward sense. (shrink)
Ways of Knowing Compassion: How Do We Come to Know, Understand, and Measure Compassion When We See It?Jennifer S. Mascaro,Marianne P. Florian,Marcia J. Ash,Patricia K. Palmer,Tyralynn Frazier,Paul Condon &Charles Raison -2020 -Frontiers in Psychology 11.detailsOver the last decade, empirical research on compassion has burgeoned in the biomedical, clinical, translational, and foundational sciences. Increasingly sophisticated understandings and measures of compassion continue to emerge from the abundance of multi- and cross-disciplinary studies. Naturally, the diversity of research methods and theoretical frameworks employed presents a significant challenge to consensus and synthesis of this knowledge. To bring the empirical findings of separate and sometimes siloed disciplines into conversation with one another requires an examination of their disparate assumptions about (...) what compassion is and how it can be known. Here, we present an integrated theoretical review of methodologies used in the empirical study of compassion. Our goal is to highlight the distinguishing features of each of these ways of knowing compassion, as well as the strengths and limitations of applying them to specific research questions. We hope this will provide useful tools for selecting methods that are tailored to explicit objectives (methods matching), taking advantage of methodological complementarity across disciplines (methods-mixing), and incorporating the empirical study of compassion into fields in which it may be missing. (shrink)
Introducing Law Students to Public Health Law through a Bed Bug Scenario.Jennifer S. Bard -2015 -Journal of Law, Medicine and Ethics 43 (s2):7-11.detailsBedbugs are tiny, wingless insects which feed on mammal blood and leave behind painful, itchy sores. Although they can live in other settings, they are most commonly found in warm, dark places inhabited by humans, like beds. After being absent in the United States for over 60 years, thanks to powerful pesticides, bed bugs, have returned in force and are present in every state and nearly every city. For reasons not entirely understood, bed bugs have developed resistance to traditional pesticides (...) such as Permethrin and are therefore difficult to control. Although commonly believed to be associated with dirty housekeeping and associated with substandard housing, bed bugs are equally likely to be present in five-star hotels as they are in homeless shelters. (shrink)
Unruly Voices: Artists’ Books and Humanities Archives in Health Professions Education.Jennifer S. Tuttle &Cathleen Miller -2020 -Journal of Medical Humanities 41 (1):53-64.detailsMartha A. Hall’s artists’ books documenting her experience of living with breast cancer offer future health professionals a unique opportunity to sit in the patient’s position of vulnerability and fear. Hall’s books have become a cornerstone of our medical humanities pedagogy at the Maine Women Writers Collection because of their emotional directness and their impact on readers. This essay examines the ways that Hall’s call for conversation with healthcare providers is enacted at the University of New England and provides a (...) model for how such works might be used at other educational institutions to encourage empathy between practitioners and patients by engaging in conversations about anger, fear, and other common reactions to life-threatening illness. We explore the unruly nature of Martha A. Hall’s narratives of illness and care, as well as how the form of the books themselves engages the reader in a deep relationship with Hall’s personal pain and her humanity itself. We explore, too, the cumulative effect of these powerful books on readers who handle them regularly, as we do in our roles as professor and archivist. (shrink)
The Effects of the COVID-19 Pandemic Lockdown on Eating, Body Image, and Social Media Habits Among Women With and Without Symptoms of Orthorexia Nervosa.Keisha C. Gobin,Jennifer S. Mills &Sarah E. McComb -2021 -Frontiers in Psychology 12.detailsThe COVID-19 pandemic is negatively impacting people’s mental health worldwide. The current study examined the effects of COVID-19 lockdown on adult women’s eating, body image, and social media habits. Furthermore, we compared individuals with and without signs of orthorexia nervosa, a proposed eating disorder. Participants were 143 women, aged 17–73 years, recruited during a COVID-19 lockdown in Canada from May-June 2020. Participants completed self-report questionnaires on their eating, body image, and social media habits during the pandemic. The Eating Habits Questionnaire (...) assessed symptoms of orthorexia nervosa. Compared to the period prior to lockdown, women with higher total orthorexia nervosa scores reported eating a lot more than usual, feeling greater pressure to diet and lose weight, thinking about food more often than usual, experiencing greater weight gain, and perceiving more pressure from social media specifically to lose weight and to exercise, compared to their healthy counterparts. We examined associations between individual EHQ subscales and perceived changes to eating and weight. Women who scored high on EHQ-Problems reported seeing more weight loss content on their social media than those who reported fewer orthorexia nervosa symptoms. Conversely, those who scored low on EHQ-Feelings reported feeling a lot less pressure to lose weight, somewhat less or a lot less pressure to lose weight or to exercise from social media specifically, and trended toward less laxative use during lockdown, compared to those who scored higher on orthorexia nervosa. And those who scored low on EHQ-Knowledge reported feeling somewhat less or a lot less pressure to lose weight than those who reported more orthorexia nervosa symptoms. Together, the findings suggest that women with symptoms of orthorexia nervosa are experiencing an exacerbation of disordered eating thoughts and behaviors during COVID-19, and that social media may be a contributing factor. (shrink)
Recovery Poets, Recovery Workers: Labor and Place in the Dialogical Way‐Finding of Homeless Addicts in Therapy.Jennifer S. Bowles -2016 -Anthropology of Consciousness 27 (1):51-74.detailsIn recent years, anthropologists have built a rich body of ethnography on the experience of addiction, including important cultural critiques of treatment systems. Yet little has been written from the perspective of those who work in the everyday to help others recover from substance abuse. In this article, I reflect on my labor as a clinical social worker providing therapy for homeless women and men who struggle with addiction. Building on the eloquence of those who seek to recover, recovery poets, (...) I demonstrate how the work of a team of frontline workers operates in a particular intersubjective realm that creates different conditions for understanding addiction and recovery than does anthropological fieldwork. By detailing the labor of recovery as I performed it using different evidence-based therapies to permit the emergence of a new consciousness, I aim to bring to center stage the complex labor of frontline workers so that their working conditions will be taken into account more often in anthropological work on addiction and treatment. (shrink)
Demonstrating Value Through Tracking Ethics Program Activities Beyond Ethics Consultations.Steven Shields,Jeff S. Matsler,JordanPotter &Susannah W. Lee -2020 -Journal of Clinical Ethics 31 (3):259-267.detailsDemonstrating value is an ongoing process and requirement for institutional survival for ethics programs. Although our ethics program has significantly increased our ethics consultation volume and maintains a robust database that tracks ethics consultation data, these data regarding ethics consultations alone do not accurately represent the program’s overall activities and value to the institution. The roles and responsibilities of clinical ethicists extend beyond clinical ethics consultation, and there are many other ways that clinical ethicists contribute and add value to their (...) institutions. This article describes our ethics program’s early efforts to systematically track ethics program activities outside of ethics consultations as a way to demonstrate additional value to the institution that goes beyond ethics consultation. By systematically tracking activities such as internal ethics education sessions, conference presentations, publications, grants, committee/policy work, and other activities, our ethics program has been able to gather substantial quantitative data that highlight our program’s numerous activities and outreach, both within and outside the institution, that provide additional value to the institution beyond our ethical consultation activities. (shrink)
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Good ethics and bad choices: the relevance of behavioral economics for medical ethics.Jennifer S. Blumenthal-Barby -2021 - Cambridge, Massachusetts: The MIT Press.detailsAn original examination of the relevance of behavioral economics for the practice of medical ethics.