Seeing is believing: The effect of subtle communication in social media on viewers' beliefs about depression and anxiety symptom trajectories

OBJECTIVE

One barrier to treatment seeking, uptake, and engagement is the belief that nothing can be done to reduce symptoms. Given the widespread use of social media to disseminate information about important issues, including psychological health, we sought to understand how the influence of social media communication regarding mental health impacts viewers' beliefs about psychopathology recovery.

METHOD

Undergraduate participants from a large Midwestern university (N = 322) were randomized to view a series of Tweets characterizing psychopathology from a fixed mindset perspective, a growth mindset perspective, or, in the control condition, Tweets unrelated to psychopathology. Afterward, they completed a series of questionnaires designed to assess beliefs about recovery from depression and anxiety.

RESULTS

Participants in the growth mindset condition endorsed less pessimistic beliefs about their ability (i.e., self-efficacy) to alleviate symptoms of depression and anxiety, and they believed these symptoms to be less stable and innate relative to those in the fixed mindset condition.

CONCLUSION

Social media communication that characterizes psychopathology from a growth mindset perspective may be a viable intervention for improving beliefs around mental health self-efficacy and the malleable nature of mental illness, particularly depression and anxiety. Clinicians may be able to use social media platforms to promote functional beliefs around mental illness.

Abnormal Oculomotor Corollary Discharge Signaling as a Trans-diagnostic Mechanism of Psychosis

BACKGROUND AND HYPOTHESIS

Corollary discharge (CD) signals are "copies" of motor signals sent to sensory areas to predict the corresponding input. They are a posited mechanism enabling one to distinguish actions generated by oneself vs external forces. Consequently, altered CD is a hypothesized mechanism for agency disturbances in psychosis. Previous studies have shown a decreased influence of CD signals on visual perception in individuals with schizophrenia-particularly in those with more severe positive symptoms. We therefore hypothesized that altered CD may be a trans-diagnostic mechanism of psychosis.

STUDY DESIGN

We examined oculomotor CD (using the blanking task) in 49 participants with schizophrenia or schizoaffective disorder (SZ), 36 bipolar participants with psychosis (BPP), and 40 healthy controls (HC). Participants made a saccade to a visual target. Upon saccade initiation, the target disappeared and reappeared at a horizontally displaced position. Participants indicated the direction of displacement. With intact CD, participants can make accurate perceptual judgements. Otherwise, participants may use saccade landing site as a proxy of pre-saccadic target to inform perception. Thus, multi-level modeling was used to examine the influence of target displacement and saccade landing site on displacement judgements.

STUDY RESULTS

SZ and BPP were equally less sensitive to target displacement than HC. Moreover, regardless of diagnosis, SZ and BPP with more severe positive symptoms were more likely to rely on saccade landing site.

CONCLUSIONS

These results suggest that altered CD may be a trans-diagnostic mechanism of psychosis.

Is self-awareness necessary to have a theory of mind?

Forty years ago, Gallup proposed that theory of mind presupposes self-awareness. Following Humphrey, his hypothesis was that individuals can infer the mental states of others thanks to the ability to monitor their own mental states in similar circumstances. Since then, advances in several disciplines, such as comparative and developmental psychology, have provided empirical evidence to test Gallup's hypothesis. Herein, we review and discuss this evidence.

Three Arguments Against Institutional Conscientious Objection, and Why They Are (Metaphysically) Unconvincing

The past decade has seen a burgeoning of scholarly interest in conscientious objection in healthcare. While the literature to date has focused primarily on individual healthcare practitioners who object to participation in morally controversial procedures, in this article we consider a different albeit related issue, namely, whether publicly funded healthcare institutions should be required to provide morally controversial services such as abortions, emergency contraception, voluntary sterilizations, and voluntary euthanasia. Substantive debates about institutional responsibility have remained largely at the level of first-order ethical debate over medical practices which institutions have refused to offer; in this article, we argue that more fundamental questions about the metaphysics of institutions provide a neglected avenue for understanding the basis of institutional conscientious objection. To do so, we articulate a metaphysical model of institutional conscience, and consider three well-known arguments for undermining institutional conscientious objection in light of this model. We show how our metaphysical analysis of institutions creates difficulties for justifying sanctions on institutions that conscientiously object. Thus, we argue, questions about the metaphysics of institutions are deserving of serious attention from both critics and defenders of institutional conscientious objection.

Adolescent OCD Patient and Caregiver Perspectives on Identity, Authenticity, and Normalcy in Potential Deep Brain Stimulation Treatment

The ongoing debate within neuroethics concerning the degree to which neuromodulation such as deep brain stimulation (DBS) changes the personality, identity, and agency (PIA) of patients has paid relatively little attention to the perspectives of prospective patients. Even less attention has been given to pediatric populations. To understand patients' views about identity changes due to DBS in obsessive-compulsive disorder (OCD), the authors conducted and analyzed semistructured interviews with adolescent patients with OCD and their parents/caregivers. Patients were asked about projected impacts to PIA generally due to DBS. All patient respondents and half of caregivers reported that DBS would impact patient self-identity in significant ways. For example, many patients expressed how DBS could positively impact identity by allowing them to explore their identities free from OCD. Others voiced concerns that DBS-related resolution of OCD might negatively impact patient agency and authenticity. Half of patients expressed that DBS may positively facilitate social access through relieving symptoms, while half indicated that DBS could increase social stigma. These views give insights into how to approach decision-making and informed consent if DBS for OCD becomes available for adolescents. They also offer insights into adolescent experiences of disability identity and "normalcy" in the context of OCD.

Against the odds: exploring individuals' pushback mechanisms against commercialized football gambling

Introduction

The need for money, the pursuit of pleasure, and the liberalized access to gambling have been documented in several pieces of literature as the drivers of gambling. Such drivers are predicated on commercialized gambling, leading to the growth of the gambling industry and constituting a structural influence that normalizes the activity among young people.

Methods

Through a qualitative inquiry, this study investigates the social agentic factors of individuals who are susceptible to gambling. Fifteen non-gamblers were recruited across three commercial cities in Africa, namely Nairobi, Lagos, and Johannesburg. We first established the gambling susceptibility of the participants: their need for money, their passion for football, ownership of a smartphone, access to the internet, and exposure to football gambling marketing.

Results

Consequently, we probed for their agency, which is indicative of why they do not gamble, despite being susceptible to engaging in the activity. Four major agentic factors were identified from the participants; knowledge of the industry's business model, conserving the integrity of football, identity of self, morality and/or religion model.

Discussion

As such, these factors may be utilized to develop an intervention program for gamblers within the geographical context.

The emergence of identity, agency and consciousness from the temporal dynamics of neural elaboration

Identity-differentiating self from external reality-and agency-being the author of one's acts-are generally considered intrinsic properties of awareness and looked at as mental constructs generated by consciousness. Here a different view is proposed. All physiological systems display complex time-dependent regulations to adapt or anticipate external changes. To interact with rapid changes, an animal needs a nervous system capable of modelling and predicting (not simply representing) it. Different algorithms must be employed to predict the momentary location of an object based on sensory information (received with a delay), or to design in advance and direct the trajectory of movement. Thus, the temporal dynamics of external events and action must be handled in differential ways, thereby generating the distinction between self and non-self ("identity") as an intrinsic computational construct in neuronal elaboration. Handling time is not what neurons are designed for. Neuronal circuits are based on parallel processing: each bit of information diverges on many neurons, each of which combines it with many other data. Spike firing reports the likelihood that the specific pattern the neuron is designed to respond to is present in the incoming data. This organization seems designed to process synchronous datasets. However, since neural networks can introduce delays in processing, time sequences can be transformed into simultaneous patterns and analysed as such. This way predictive algorithms can be implemented, and continually improved through neuronal plasticity. To successfully interact with the external reality, the nervous system must model and predict, but also differentially handle perceptual functions or motor activity, by putting in register information that becomes available at different time moments. Also, to learn through positive/negative reinforcement, modelling must establish a causal relation between motor control and its consequences: the contrast between phase lag in perception and phase lead (and control) in motor programming produces the emergence of identity (discerning self from surrounding) and agency (control on actions) as necessary computational constructs to model reality. This does not require any form of awareness. In a brain, capable of producing awareness, these constructs may evolve from mere computational requirements into mental (conscious) constructs.

Irruption and Absorption: A 'Black-Box' Framework for How Mind and Matter Make a Difference to Each Other

Cognitive science is confronted by several fundamental anomalies deriving from the mind-body problem. Most prominent is the problem of mental causation and the hard problem of consciousness, which can be generalized into the hard problem of agential efficacy and the hard problem of mental content. Here, it is proposed to accept these explanatory gaps at face value and to take them as positive indications of a complex relation: mind and matter are one, but they are not the same. They are related in an efficacious yet non-reducible, non-observable, and even non-intelligible manner. Natural science is well equipped to handle the effects of non-observables, and so the mind is treated as equivalent to a hidden 'black box' coupled to the body. Two concepts are introduced given that there are two directions of coupling influence: (1) irruption denotes the unobservable mind hiddenly making a difference to observable matter, and (2) absorption denotes observable matter hiddenly making a difference to the unobservable mind. The concepts of irruption and absorption are methodologically compatible with existing information-theoretic approaches to neuroscience, such as measuring cognitive activity and subjective qualia in terms of entropy and compression, respectively. By offering novel responses to otherwise intractable theoretical problems from first principles, and by doing so in a way that is closely connected with empirical advances, irruption theory is poised to set the agenda for the future of the mind sciences.

The mediating role of hope and life satisfaction

BACKGROUND

Children affected by war and political violence deploy agentic competencies to cope with trauma symptoms and psychological difficulties. However, it does not always act as a protective factor to help them adjust to potentially traumatic events.

AIMS

We expected to explore the association between agency, trauma symptoms and psychological difficulties and the mediating role of hope and life satisfaction in a group of child victims of military violence in Palestine.

METHODS

965 children aged 8 to 14 were assessed with self-reported measures, War Child Agency Assessment Scale, Children Revised Impact of events scale, Strengths and difficulties scale, Child Hope Scale and Brief Multidimensional Students Life Satisfaction Scale. Structural Equation Modelling was performed having Agency as a predictor, trauma symptoms, psychological difficulties as an outcome variable and life satisfaction and hope as a mediator.

RESULTS

We found a direct and positive effect of agency on trauma symptoms, psychological difficulties, and life satisfaction and hope on the two dependent variables. Life satisfaction and hope mediated the association between agency and the outcome variables.

CONCLUSION

Agency can help defend children from trauma and psychological maladaptation when it acts on life satisfaction and hope. At the same time, it might worsen psychological dysfunctions when working directly on trauma symptoms and difficulties. Clinical interventions must help children to foster agentic resources in activating hope and life satisfaction.

Machine vision situations: Tracing distributed agency

This article proposes a new method for tracing and examining agency in heterogeneous assemblages, focusing on the role of machine vision technologies in creative works. We introduce the concept of the "machine vision situation" and define it as the moment in which machine vision technologies come into play and make a difference to the course of events. By taking situations as the unit of analysis, we identify moments at which machine vision technologies take part in actions without reducing them to either tools or protagonists, instead allowing for more complex agential entanglements between human and non-human actors. Grounded on an interdisciplinary theoretical framework, this article demonstrates how an analytical unit such as the machine vision situation is a valuable method for tracing how agency is distributed. We illustrate this through three examples by applying the method to creative works - narratives, digital games, and artworks - revealing key aspects of distributed agency and calling attention to the excess, complications, and messy entanglements that might otherwise be overlooked in analyses of agential assemblages. The machine vision situation is shown to be a flexible unit of analysis that can be productively incorporated in both quantitative and qualitative studies and applied to other contexts in which human and non-human agencies interact.

Moral submissiveness: social origin as a vulnerability for well-being on a warming planet

In recent years, the emotional experience of climate change has been studied extensively from fields like psychology, theology, sociology, and philosophy. It is crucial to analyze these results for possible vulnerability with regard to well-being. While climate justice research raises awareness of the current (social) situation of the participants in relation to the experience of climate change, the research on climate emotions seems to overlook the participant's former social situation - their family of origin. Previous studies on injustice have shown however that it is precisely the way people were educated on emotion work that has a significant impact on their experiences and sense of control in the situation. Given the importance of this sense of control for mental well-being, I argue consequently that social origin is a vulnerability for well-being in the (emotional) experience of climate change, perpetuating climate injustice, based on this combination of studies from different epochs. Therefore, in the interest to protect well-being on a warming planet, it is crucial to raise awareness of the impact of social origin.

"We are the future": Advant-aged women speak-out through spoken word poetry

This study aims to investigate women between the ages of 50 and 70 who write and perform spoken word poetry, through which they wish to lead positive social change, by turning the culture of silence into open discourse. This period represents a new phase of life. These women are at an "in-between" phase of being no longer young but not yet old and are between life roles. This is a new age group that has not yet been studied. We argue that this stage of life requires a new term. The term chosen for this study is advant-age because it implies the advantages and opportunities that this period of life affords. Although this group of women is growing in relation to the general population, the ageism and sexism they experience are increasing, creating a gradual process of social exclusion and reduction in their agency. Spoken Word Poetry (SWP) is written on a page but performed live in front of an audience. It is a poetic piece that includes rhythm, rhyme, and sometimes humor, which help convey complex messages with finesse. The importance of the current research lies in revealing a new and unresearched social phenomenon that has been developing in Israel in recent years: Advant-aged women are discussing issues that society usually silences, using methods that traditionally have been associated with younger groups. Through SWP, advant-aged women are enabling the possibility of raising these issues for public discussion and creating an opportunity for social change.

Can agentic messages help? Linguistic strategies to counteract voice-based sexual orientation discrimination

Gay men who believe to sound 'gay' expect to be discriminated against because of their voices and gay-sounding men are discriminated against in the hiring process. We examined whether uttering an agency-based message decreased discrimination expectancy and enactment. In Study 1a (N = 256; gay and bisexual men) and Study 1b (N = 216; gay men), speakers uttered agentic (vs. neutral) messages. We assessed their self-perception as gay sounding, agency self-attribution and discrimination expectancy. Uttering agentic (vs. neutral) messages made the speakers self-perceive as more agentic and this decreased discrimination expectancy. Additionally, self-perception as gay sounding predicted discrimination expectancy. In Study 2 (N = 466), heterosexual participants listened to gay- and straight-sounding speakers uttering either neutral or agentic messages and rated them in terms of agency and employability. Gay-sounding speakers uttering agentic messages were less likely to be discriminated against than when uttering neutral messages. Results show the positive impact of linguistic strategies involving agentic messages to reduce discrimination expectancy and hiring biases.

Trait Boredom as a Lack of Agency: A Theoretical Model and a New Assessment Tool

Trait boredom plays a significant role in well-being. However, this construct suffers from conceptual ambiguity and measurement problems. The aim of this study was to propose a comprehensive theory and a strong assessment tool to address these limitations. We defined trait boredom as the frequent experience of state boredom resulting from a chronic lack of agency. We developed a six-item self-report scale of the tendency to often experience boredom. Results confirmed a uni-dimensional scale with strong psychometric properties, including adequate internal consistency (ω = .84-.93), interindividual stability (69.04% of variance accounted by a trait factor), and acceptable model fit (CFI = .977-.998, TLI = .962-.997, RMSEA = .025-.090, SRMR = .014-.029). Results confirmed the validity of the scale by showing its associations with related measures. Our findings provide clarity on trait boredom and a strong, new measure to be used in future work.

The cognitive neuroscience of self-awareness: Current framework, clinical implications, and future research directions

Self-awareness, the ability to take oneself as the object of awareness, has been an enigma for our species, with different answers to this question being provided by religion, philosophy, and, more recently, science. The current review aims to discuss the neurocognitive mechanisms underlying self-awareness. The multidimensional nature of self-awareness will be explored, suggesting how it can be thought of as an emergent property observed in different cognitive complexity levels, within a predictive coding approach. A presentation of alterations of self-awareness in neuropsychiatric conditions will ground a discussion on alternative frameworks to understand this phenomenon, in health and psychopathology, with future research directions being indicated to fill current gaps in the literature. This article is categorized under: Philosophy > Consciousness Psychology > Brain Function and Dysfunction Neuroscience > Cognition.

Between 'block course relationships' and abstinence: cultures of sexuality among students at Addis Ababa University

Inspired by African and other feminist scholarship on gender, sexuality and agency, this article studies narrations of norms and practices in sexual relationships between university students. A main aim of the article is to move beyond the problem focus in earlier scholarship on women, sexuality and reproduction, and to identify potential spaces of freedom and expansion of female agency. The article is based on qualitative research conducted with students at Addis Ababa University. The findings a vivid space for male-female relationships. Study participants report being sexually engaged as "the new normal" and claim that many female students are active both in seeking relationships and in discontinuing them. These ideas and practices indicate increasing female agency and emerge in stark contrast to dominant social norms for sexual conduct, which demand chastity before marriage, particularly for women. Students are conscious of this discrepancy and bring it up in their narratives. Findings also show that some students prefer to stay abstinent and make an effort to avoid sexual relations. We argue that expressions of female agency are evident not only in norm-transgressive sexual conduct, but also in norm-conforming strategies of sexual abstinence.

A test of the Morality-Agency-Communion (MAC) model of respect and liking across positive and negative traits

The Morality-Agency-Communion (MAC) model of respect and liking suggests that traits linked with morality are important for respect and liking; traits related to competence or assertiveness are important for respect and traits related to warmth are important for liking. However, tests of this model have tended not to consider traits related to immorality, incompetence, lack of assertiveness or coldness. This study addressed this issue by utilizing a within-subjects design in which participants were required to rate their respect and liking for individuals with specific trait types across four categories (moral; competence; assertiveness; and warmth) at three levels (positive, negative and neutral). The central tenets of the MAC model were supported for 'positive' traits (morality, competence, assertiveness and warmth). However, for 'negative' traits (immorality, incompetence and lack of assertiveness), individuals were similarly not liked and not respected. Individuals who were cold were respected more than liked. The findings of this study extend the MAC model by indicating that the amount that individuals are respected versus liked depends not only on trait type but also whether a trait is positive or negative.

And say the AI responded? Dancing around 'autonomy' in AI/human encounters

The article explores technology-human relations in a time of artificial intelligence (AI) and in the context of long-standing problems in social theory about agency, nonhumans, and autonomy. Most theorizations of AI are grounded in dualistic thinking and traditional views of technology, oversimplifying real-world settings. This article works to unfold modes of existence at play in AI/human relations. Materials from ethnographic fieldwork are used to highlight the significance of autonomy in AI/human relations. The analysis suggests that the idea of autonomy is a double-edged sword, showing that humans not only coordinate their perception of autonomy but also switch between registers by sometimes ascribing certain autonomous features to the AI system and in other situations denying the system such features. As a result, AI/human relations prove to be not so much determined by any ostensive delegation of tasks as by the way in which AI and humans engage with each other in practice. The article suggests a theory of relationality that redirects focus away from questions of agency towards questions of what it means to be in relations.

Believing That We Can Change Our World for the Better: A Triple-A (Agent-Action-Aim) Framework of Self-Efficacy Beliefs in the Context of Collective Social and Ecological Aims

PUBLIC ABSTRACT

Many people do not act together against climate change or social inequalities because they feel they or their group cannot make a difference. Understanding how people come to feel that they can achieve something (a perception of self-efficacy) is therefore crucial for motivating people to act together for a better world. However, it is difficult to summarize already existing self-efficacy research because previous studies have used many different ways of naming and measuring it. In this article, we uncover the problems that this raises and propose the triple-A framework as a solution. This new framework shows which agents, actions, and aims are important for understanding self-efficacy. By offering specific recommendations for measuring self-efficacy, the triple-A framework creates a basis for mobilizing human agency in the context of climate change and social injustice.

The Concept of Child-Centred Care in Healthcare: A Scoping Review

Although child-centred care is increasingly referred to within the nursing literature, a clear definition of child-centred care and clarity around the concept is yet to be achieved. The objectives of this review were to examine the following: (1) What constitutes the concept of child-centred care in healthcare? (2) How has the concept of child-centred care developed? (3) What is the applicability of child-centred care and what are its limitations? (4) How does the concept of child-centred care benefit and inform children's healthcare? In total, 2984 papers were imported for screening, and, following the removal of duplicates and screening, 21 papers were included in the scoping review. The findings suggest that child-centred care is an emerging, ambiguous poorly defined concept; no clear consensus exists about what constitutes child-centred care. Although it seems antithetical to argue against child-centred care, little robust evidence was identified that demonstrates the impact and benefit of child-centred care. If child-centred care is to be a sustainable, convincing model to guide practice and compete with other models of care, it needs to establish robust evidence of its effectiveness, the impact on children and their families, as well as the wider impacts on the healthcare system.

Basic or Adaptation: The Assessment and Heritability of a Brief Measure of Agency

The interpersonal circumplex describes two major axes of personality that guide much of social behavior. Agency, one half of the interpersonal circumplex, refers to relatively stable behavioral patterns that center on self-focused dominance and assertiveness. Past empirical work on agency tends to treat the dimension as a characteristic adaptation, rather than a basic component of personality, in part due to the relatively large gender difference in agency with masculine individuals tending to behave more agentic. However, the psychometric overlap between agency and the most closely linked big five dimension, extraversion, is not well-established, and no behavior genetic work has documented evidence concerning the role of genetic and environmental influences. It is unclear whether agency is more similar to a personality trait, with no evidence of shared environmental influence and moderate heritability, or a characteristic adaptation, with some evidence for shared environmental influence and possibly lower heritability. We used the Midlife Development in the United States study to examine agency, big five, and generativity with replication and robustness check (Nnon-twins = 5,194; Ntwins = 1,914; NMilwaukee = 592). Results indicated that agency was higher in men (d = -.24), moderately heritable (44.4%), strongly correlated with extraversion (r = .51), moderately correlated with generativity (r = .36), and that approximately 40% of the variance in agency was shared with the big five. Agency also changed strongly with extraversion and openness, but less so generativity. Altogether, these results indicate that agency functions similar to other basic personality dimensions but is not clearly a dispositional trait.

Integration of Psychosocial Theory into Palliative Care: Implications for Care Planning and Early Palliative Care

Palliative care improves patients' symptoms, quality of life and family satisfaction with caregiving, reduces hospital admissions and promotes alignment of medical care with the patient's needs and goals. This article proposes the utility of integrating three psychosocial theories into standard palliative care with implications for care planning, early palliative care and optimizing quality of life. First, Control Theory focuses on the complex juxtaposition of promoting agency/empowerment in patients and carers and coping with often highly uncertain outcomes. Second, Optimal Matching Theory accounts for the alignment of need and provision of care to potentiate the quality of life effects of supportive care in a complex social process involving health care providers, patients and carers. Third, Hope Theory represents a dynamic process, which is marked by variation in the qualities of hope as the patient and carer confront challenges during palliative care. Future work will be translational in nature to adapt both assessment and interventions based on this theoretically driven augmentation of palliative care as well as to evaluate whether it provides a conceptual framework that has incremental utility in palliative care planning.

The Role of Agentive and Physical Forces in the Neural Representation of Motion Events

How does the brain represent information about motion events in relation to agentive and physical forces? In this study, we investigated the neural activity patterns associated with observing animated actions of agents (e.g., an agent hitting a chair) in comparison to similar movements of inanimate objects that were either shaped solely by the physics of the scene (e.g., gravity causing an object to fall down a hill and hit a chair) or initiated by agents (e.g., a visible agent causing an object to hit a chair). Using an fMRI-based multivariate pattern analysis (MVPA), this design allowed testing where in the brain the neural activity patterns associated with motion events change as a function of, or are invariant to, agentive versus physical forces behind them. A total of 29 human participants (nine male) participated in the study. Cross-decoding revealed a shared neural representation of animate and inanimate motion events that is invariant to agentive or physical forces in regions spanning frontoparietal and posterior temporal cortices. In contrast, the right lateral occipitotemporal cortex showed a higher sensitivity to agentive events, while the left dorsal premotor cortex was more sensitive to information about inanimate object events that were solely shaped by the physics of the scene.

A Two-Phase Qualitative Enquiry Into Storytelling's Potential to Support Palliative Care Patient-Led Change, Using a Systematic Review Approach

A terminal diagnosis can diminish an individual's sense of agency and identity. Leading change appears to restore a sense of agential self. The first phase of this literature review explores factors influencing patient-led change across the palliative care ecosystem. The second phase illuminates how storytelling can support palliative care patients in leading ecosystem-wide change. 35 studies were identified in Phase 1 and 36 in Phase 2. This research highlights the need to situate patient leadership activity within a palliative care ecosystem to understand factors likely to support or hinder patient leadership activity within it. The evidence indicates the potential use of storytelling to support patients with a life-limiting illness to lead change across the palliative care ecosystem. This challenges current conceptualisations of such patients and offers them instead as an additional source of palliative care support.

Medical professionals' agency and pharmaceuticalization: Physician-industry relations in Russia

In the contemporary world pharmaceuticals have become a go-to answer to a growing number of questions. This process of pharmaceuticalization gives rise to a concern with the increasing influence of the pharmaceutical industry on physicians' decision-making. Critics suggest that companies' for-profit-interests might compromise the integrity of medical practice. This article employs qualitative research methodology to explore how Russian physicians deal with the industry's efforts to expand and shape the use of pharmaceuticals. By bridging perspectives of social studies of science and sociology of professions, we offer a contextualized account of physicians' daily practices and interpretations related to pharmaceuticalization. The findings question conventional assumptions of physician-industry relations and allow to delineate a new form of medical professionalism that emerges in the context of pharmaceuticalization and cannot be reduced to either "resisting" industry marketing activities or "giving in" to them and thus corrupting biomedical expertise. Instead, the ways in which physicians navigate abundant sources of knowledge and use industry resources to overcome constraints of their organizational environment attest to mundane forms of agency exercised by physicians in their relations with industry.

Drivers of child marriages for girls: A prospective study in a low-income African setting

Child marriage has adverse consequences for young girls. Cross-sectional research has highlighted several potential drivers of early marriage. We analyse drivers of child marriage using longitudinal data from rural Malawi, where rates of child marriage are among the highest in the world despite being illegal. Estimates from survival models show that 26% of girls in our sample marry before age 18. Importantly, girls report high decision-making autonomy vis-à-vis the decision to marry. We use multivariate Cox proportional hazard models to explore the role of 1) poverty and economic factors, 2) opportunity or alternatives to marriage, 3) social norms and attitudes, 4) knowledge of the law and 5) girls' agency. Only three factors are consistently associated with child marriage. First, related to opportunities outside marriage, girls lagging in school at survey baseline have significantly higher rates of child marriage than their counterparts who were at or near grade level. Second, related to social norms, child marriage rates are significantly lower among respondents whose caregivers perceive that members of their community disapprove of child marriage. Third, knowledge of the law has a positive coefficient, a surprising result. These findings are aligned with the growing qualitative literature describing contexts where adolescent girls are more active agents in child marriages.

Identity status and narrative identity processes in female adolescents' stories about committing crimes and being convicted

INTRODUCTION

Adolescent delinquency has been suggested to evolve from a normative motivation to establish independence and identity. However, few studies have examined this in detail, especially in young women. The aim was, therefore, to investigate identity formation in adolescent females with limited delinquency by focusing on identity status and identity processes in narratives about committing crimes and being convicted.

METHODS

Interviews with 10 females, 15-18 years old, sentenced to youth service in three Swedish cities were conducted on Zoom.

RESULTS

The results showed an equal distribution of all identity statuses within the group. Thematic analysis of their stories about crime and conviction showed that delinquency was described in terms of exploration and commitment, although commitment appeared more clearly. Social relations, in particular peers, played an important role in both committing as well as desisting from delinquency. In terms of narrative processes, the stories contained elements of agency, although diminishing of one's own capability and/or responsibility was common, and meaning making, mostly lesson learning, usually pertained to behaviors, interactional rules, or norms.

CONCLUSION

These findings point to the importance of viewing delinquency among young women in a social and developmental context, where delinquency may be a part of the process of identity formation. Interventions focusing on expressing needs of belonging as well as finding oneself in more adaptive ways are warranted, where supporting pro-social relations and contexts is a suggested focus.

Common ground in AAC: how children who use AAC and teaching staff shape interaction in the multimodal classroom

Children who use augmentative and alternative communication (AAC) are multimodal communicators. However, in classroom interactions involving children and staff, achieving mutual understanding and accomplishing task-oriented goals by attending to the child's unaided AAC can be challenging. This study draws on excerpts of video recordings of interactions in a classroom for 6-9-year-old children who used AAC to explore how three child participants used the range of multimodal resources available to them - vocal, movement-based, and gestural, technological, temporal - to shape (and to some degree, co-control) classroom interactions. Our research was concerned with examining achievements and problems in establishing a sense of common ground and the realization of child agency. Through detailed multimodal analysis, this paper renders visible different types of practices rejecting a request for clarification, drawing new parties into a conversation, disrupting whole-class teacher talk-through which the children in the study voiced themselves in persuasive ways. It concludes by suggesting that multimodal accounts paint a more nuanced picture of children's resourcefulness and conversational asymmetry that highlights children's agency amidst material, semiotic, and institutional constraints.

What happens when people develop dementia whilst working? An exploratory multiple case study

PURPOSE

This study is an in-depth exploration of the unfolding experiences of five persons who developed dementia while still in paid work/employment, and of their significant others. Namely, we explore how they experienced the actions and decisions taken with respect to work, and what the consequences meant to them.

METHODS

A qualitative longitudinal case study design with multiple cases was used, including five participants with dementia and significant others of their choice. Interviews were undertaken longitudinally and analysed with the Formal Data-Structure Analysis approach.

RESULTS

The joint analysis resulted in two intertwined themes: 1) The significance and consequences of a dementia diagnosis: a double-edged trigger, and 2) Sensemaking and agency. The prevalent images of what dementia is, who can/cannot get it and what it will bring, were revealed as the critical aspects. Having the opportunity to make sense of what has happened and participate in decision-making, contributed decisively to the participants' experiences.

CONCLUSIONS

Findings illustrate how a dementia diagnosis is alien in work-life, but once diagnosed, it may trigger self-fulfiling expectations based upon stereotypical understanding of dementia. A shift is needed from a deficit-focused perspective, to viewing people with dementia as citizens capable of agency.

The feasibility of artificial consciousness through the lens of neuroscience

Interactions with large language models (LLMs) have led to the suggestion that these models may soon be conscious. From the perspective of neuroscience, this position is difficult to defend. For one, the inputs to LLMs lack the embodied, embedded information content characteristic of our sensory contact with the world around us. Secondly, the architectures of present-day artificial intelligence algorithms are missing key features of the thalamocortical system that have been linked to conscious awareness in mammals. Finally, the evolutionary and developmental trajectories that led to the emergence of living conscious organisms arguably have no parallels in artificial systems as envisioned today. The existence of living organisms depends on their actions and their survival is intricately linked to multi-level cellular, inter-cellular, and organismal processes culminating in agency and consciousness.

Temporal Dynamics of Brain Activity Predicting Sense of Agency over Muscle Movements

Our muscles are the primary means through which we affect the external world, and the sense of agency (SoA) over the action through those muscles is fundamental to our self-awareness. However, SoA research to date has focused almost exclusively on agency over action outcomes rather than over the musculature itself, as it was believed that SoA over the musculature could not be manipulated directly. Drawing on methods from human-computer interaction and adaptive experimentation, we use human-in-the-loop Bayesian optimization to tune the timing of electrical muscle stimulation so as to robustly elicit a SoA over electrically actuated muscle movements in male and female human subjects. We use time-resolved decoding of subjects' EEG to estimate the time course of neural activity which predicts reported agency on a trial-by-trial basis. Like paradigms which assess SoA over action consequences, we found that the late (post-conscious) neural activity predicts SoA. Unlike typical paradigms, however, we also find patterns of early (sensorimotor) activity with distinct temporal dynamics predicts agency over muscle movements, suggesting that the "neural correlates of agency" may depend on the level of abstraction (i.e., direct sensorimotor feedback versus downstream consequences) most relevant to a given agency judgment. Moreover, fractal analysis of the EEG suggests that SoA-contingent dynamics of neural activity may modulate the sensitivity of the motor system to external input.SIGNIFICANCE STATEMENT The sense of agency, the feeling of "I did that," when directing one's own musculature is a core feature of human experience. We show that we can robustly manipulate the sense of agency over electrically actuated muscle movements, and we investigate the time course of neural activity that predicts the sense of agency over these actuated movements. We find evidence of two distinct neural processes: a transient sequence of patterns that begins in the early sensorineural response to muscle stimulation and a later, sustained signature of agency. These results shed light on the neural mechanisms by which we experience our movements as volitional.

The agency domain and behavioral interactions: assessing positive animal welfare using the Five Domains Model

Animal welfare denotes how an animal experiences their life. It represents the overall mental experiences of an animal and is a subjective concept that cannot be directly measured. Instead, welfare indicators are used to cautiously infer mental experiences from resource provisions, management factors, and animal-based measures. The Five Domains Model is a holistic and structured framework for collating these indicators and assessing animal welfare. Contemporary approaches to animal welfare management consider how animals can be given opportunities to have positive experiences. However, the uncertainty surrounding positive mental experiences that can be inferred has resulted in risk-averse animal welfare scientists returning to the relative safety of positivism. This has meant that aspects of positive welfare are often referred to as animal 'wants'. Agency is a concept that straddles the positivist-affective divide and represents a way forward for discussions about positive welfare. Agency is the capacity of individual animals to engage in voluntary, self-generated, and goal-directed behavior that they are motivated to perform. Discrete positive emotions are cautiously inferred from these agentic experiences based on available knowledge about the animal's motivation for engaging in the behavior. Competence-building agency can be used to evaluate the potential for positive welfare and is represented by the Behavioral Interactions domain of the Five Domains Model. In 2020, The Model was updated to, amongst other things, include consideration of human-animal interactions. The most important aspect of this update was the renaming of Domain 4 from "Behavior" to "Behavioral Interactions" and the additional detail added to allow this domain's purpose to be clearly understood to represent an animal's opportunities to exercise agency. We illustrate how the Behavioral Interactions domain of The Model can be used to assess animals' competence-building agency and positive welfare. In this article, we use the examples of sugar gliders housed in captivity and greyhounds that race to illustrate how the agentic qualities of choice, control, and challenge can be used to assess opportunities for animals to exercise agency and experience positive affective engagement.

Complaints: Mechanisms for prisoner participation?

In prisons, participatory mechanisms can foster important outcomes including fairness, legitimacy and dignity. Complaints are one significant (symbolic) mechanism facilitating prisoner participation. Ombud institutions/Ombudsmen handle complaints externally, providing unelected accountability mechanisms and overseeing prisons around the world. A fair complaints process can stimulate prisoner voice, agency and rights protection, potentially averting self-harm and violence, and facilitating systemic improvements. However, complaints mechanisms are little studied. Addressing this gap, we: i) contextualise discussion by demonstrating that prisoners' actions have directly shaped complaints mechanisms available today; ii) outline prison complaints mechanisms in the case study jurisdiction of England and Wales; and iii) provide a critical review of literature to assess whether prison complaints systems are, in practice, participatory, inclusive and fair? We conclude that complaints mechanisms hold clear potential to enhance prison legitimacy, facilitate prisoner engagement and agency, and improve wellbeing and safety. However, myriad barriers prevent prisoners from participating in complaints processes, including culture, fear, accessibility, timeliness, emotional repression, and bureaucracy. The process of complaining and experiences of these barriers are uneven across different groups of prisoners. Our article provides a springboard for future empirical research.

Agency in Reproduction

While niche construction theory and developmental approaches to evolution have brought to the front the active role of organisms as ecological and developmental agents, respectively, the role of agents in reproduction has been widely neglected by organismal perspectives of evolution. This paper addresses this problem by proposing an agential view of reproduction and shows that such a perspective has implications for the explanation of the origin of modes of reproduction, the evolvability of reproductive modes, and the coevolution between reproduction and social behavior. After introducing the two prevalent views of agency in evolutionary biology, namely those of organismal agency and selective agency, I contrast these two perspectives as applied to the evolution of animal reproduction. Taking eutherian pregnancy as a case study, I wonder whether organismal approaches to agency forged in the frame of niche construction and developmental plasticity theories can account for the goal-directed activities involved in reproductive processes. I conclude that the agential role of organisms in reproduction is irreducible to developmental and ecological agency, and that reproductive goals need to be included into our definitions of organismal agency. I then explore the evolutionary consequences of endorsing an agential approach to reproduction, showing how such an approach might illuminate our understanding of the evolutionary origination and developmental evolvability of reproductive modes. Finally, I analyze recent studies on the coevolution between viviparity and social behavior in vertebrates to suggest that an agential notion of reproduction can provide unforeseen links between developmental and ecological agency.

Impaired cardiac modulation in patients with functional seizures: Results from a face intensity judgment task

OBJECTIVE

Although interoceptive abnormality in patients with functional seizure (FSs) has been demonstrated using explicit tasks, implicit measurements of interoception such as the effect of interoception on perceptual brain processes have not been investigated. It has been shown that perception is normally modulated by interoceptive signals related to the different phases (systole vs diastole) of the cardiac cycle (cardiac modulation effect). Given our previous findings using explicit measures of interoception, we hypothesized that cardiac modulation would be impaired in FSs.

METHODS

Thirty-two patients with FSs and 30 age- and sex-matched non-clinical individuals conducted a face intensity judgment task, in which their intensity rating when fearful or neutral faces was presented was compared between systolic and diastolic phases. They also conducted the heartbeat discrimination task as a measure of their capacity to integrate both interoceptive and exteroceptive information.

RESULTS

Patients with FSs had impaired cardiac modulation of the perception of neutral faces (corrected p = .044). Individual differences in the heartbeat discrimination task predicted the degree to which cardiac modulation occurred across the whole group (p = .028). This cardiac modulation effect was significantly associated with seizure severity (p = .021). Regardless of cardiac phase, patients rated fearful facial expressions as less intense compared to control participants (p = .006).

SIGNIFICANCE

These findings highlight impaired implicit cardiac modulation effects in patients with FSs. This reflects interoceptive dysfunction in patients with FSs, and an inability of the brain to integrate interoceptive signaling with perceptual processing. This may have implications for our understanding of the pathophysiology in FSs and inform novel diagnostic approaches.

Longitudinal assessment of mental health after a flood: roles of social support, hope, recovery stressors, and prior lifetime trauma

OBJECTIVES

Severe weather events have mental health consequences for survivors that may change over time. We assessed post-flood mental health longitudinally in three groups of mostly middle-aged and older adults who varied in current and prior severe weather experiences.

METHOD

Predictors of central interest were age, perceived social support, state hope (including agency and pathways), recovery stressors, and prior lifetime trauma. Criterion variables included symptoms of depression, post-traumatic stress disorder (PTSD), and worry.

RESULTS

Analyses of variance yielded significant Disaster Exposure Group x Wave interactions for depression and PTSD symptoms. Those with flooded homes and properties had elevated symptoms at Wave 1 which were reduced at Wave 2. Older age was associated with fewer symptoms of depression, PTSD, and worry. Recovery stressors and lifetime trauma predicted more PTSD symptoms. Greater agency predicted less PTSD and depression symptoms, whereas pathways predicted less worry.

CONCLUSION

These data show that mental health symptoms may decrease over time for those directly impacted by severe flooding. State hope appears to contribute to better mental health after exposure to a devastating flood. Implications for understanding the dynamic relationships among risk variables and positive factors that promote post-disaster mental health in the years after a flood are considered.

Agential autonomy and biological individuality

What is a biological individual? How are biological individuals individuated? How can we tell how many individuals there are in a given assemblage of biological entities? The individuation and differentiation of biological individuals are central to the scientific understanding of living beings. I propose a novel criterion of biological individuality according to which biological individuals are autonomous agents. First, I articulate an ecological-dynamical account of natural agency according to which, agency is the gross dynamical capacity of a goal-directed system to bias its repertoire to respond to its conditions as affordances. Then, I argue that agents or agential dynamical systems can be agentially dependent on, or agentially autonomous from, other agents and that this agential dependence/autonomy can be symmetrical or asymmetrical, strong or weak. Biological individuals, I propose, are all and only those agential dynamical systems that are strongly agentially autonomous. So, to determine how many individuals there are in a given multiagent aggregate, such as multicellular organism, a colony, symbiosis, or a swarm, we first have to identify how many agential dynamical systems there are, and then what their relations of agential dependence/autonomy are. I argue that this criterion is adequate to the extent that it vindicates the paradigmatic cases, and explains why the paradigmatic cases are paradigmatic, and why the problematic cases are problematic. Finally, I argue for the importance of distinguishing between agential and causal dependence and show the relevance of agential autonomy for understanding the explanatory structure of evolutionary developmental biology.

The agential perspective: Countermapping the modern synthesis

We compare and contrast two theoretical perspectives on adaptive evolution-the orthodox Modern Synthesis perspective, and the nascent Agential Perspective. To do so, we develop the idea from Rasmus Grønfeldt Winther of a 'countermap', as a means for comparing the respective ontologies of different scientific perspectives. We conclude that the modern Synthesis perspective achieves an impressively comprehensive view of a universal set of dynamical properties of populations, but at the considerable cost of radically distorting the nature of the biological processes that contribute to evolution. For its part, the Agential Perspective offers the prospect of representing the biological processes of evolution with much greater fidelity, but at the expense of generality. Trade-offs of this sort are endemic to science, and inevitable. Recognizing them helps us to avoid the pitfalls of 'illicit reification', i.e. the mistake of interpreting a feature of a scientific perspective as a feature of the non-perspectival world. We argue that much of the traditional Modern Synthesis representation of the biology of evolution commits this illicit reification.

Hybrid Life: Integrating biological, artificial, and cognitive systems

Artificial life is a research field studying what processes and properties define life, based on a multidisciplinary approach spanning the physical, natural, and computational sciences. Artificial life aims to foster a comprehensive study of life beyond "life as we know it" and toward "life as it could be," with theoretical, synthetic, and empirical models of the fundamental properties of living systems. While still a relatively young field, artificial life has flourished as an environment for researchers with different backgrounds, welcoming ideas, and contributions from a wide range of subjects. Hybrid Life brings our attention to some of the most recent developments within the artificial life community, rooted in more traditional artificial life studies but looking at new challenges emerging from interactions with other fields. Hybrid Life aims to cover studies that can lead to an understanding, from first principles, of what systems are and how biological and artificial systems can interact and integrate to form new kinds of hybrid (living) systems, individuals, and societies. To do so, it focuses on three complementary perspectives: theories of systems and agents, hybrid augmentation, and hybrid interaction. Theories of systems and agents are used to define systems, how they differ (e.g., biological or artificial, autonomous, or nonautonomous), and how multiple systems relate in order to form new hybrid systems. Hybrid augmentation focuses on implementations of systems so tightly connected that they act as a single, integrated one. Hybrid interaction is centered around interactions within a heterogeneous group of distinct living and nonliving systems. After discussing some of the major sources of inspiration for these themes, we will focus on an overview of the works that appeared in Hybrid Life special sessions, hosted by the annual Artificial Life Conference between 2018 and 2022. This article is categorized under: Neuroscience > Cognition Philosophy > Artificial Intelligence Computer Science and Robotics > Robotics.

Agency effects on the binding of event elements in episodic memory

Representing events in episodic memory in a coherent manner requires that their constituent elements are bound together. So far, only few moderators of these binding processes have been identified. Here we investigate whether the presence of an agentic element in an event facilitates binding. The results from six experiments provided no evidence for a facilitating effect of agency on the binding of event elements. In addition, binding effects were only found when event elements were presented simultaneously, but not when they were presented sequentially pairwise, contrary to previous findings. The results suggest that the presence of an agentic element in an event does not, or only to a very limited extent, contribute to the formation of coherent memory representations and that additional processes may be required when binding event elements across temporarily divided encoding episodes. These findings add to a growing body of research regarding moderators and processes relevant for the binding of event elements in episodic memory. Explanations of these findings and directions for future research are discussed.

What does it mean to be an agent?

Artificial intelligence (AI) has posed numerous legal-ethical challenges. These challenges are particularly acute when dealing with AI demonstrating substantial computational prowess, which is then correlated with agency or autonomy. A common response to considering this issue is to inquire whether an AI system is "conscious" or not. If it is, then it could constitute an agent, actor, or person. This framing is, however, unhelpful since there are many unresolved questions about consciousness. Instead, a practical approach is proposed, which could be used to better regulate new AI technologies. The value of the practical approach in this study is that it (1) provides an empirically observable, testable framework that contains predictive value; (2) is derived from a data-science framework that uses semantic information as a marker; (3) relies on a self-referential logic which is fundamental to agency; (4) enables the "grading" or "ranking" of AI systems, which provides an alternative method (as opposed to current risk-tiering approaches) and measure to determine the suitability of an AI system within a specific domain (e.g., such as social domains or emotional domains); (5) presents consistent, coherent, and higher informational content as opposed to other approaches; (6) fits within the conception of what informational content "laws" are to contain and maintain; and (7) presents a viable methodology to obtain "agency", "agent", and "personhood", which is robust to current and future developments in AI technologies and society.

Incorporating personal narratives in positive psychology interventions to manage chronic pain

In this perspective paper, we argue for incorporating personal narratives in positive psychology interventions for chronic pain. Narratives refer to the telling and retelling of events. Narratives detail accounts of events and provide rich, in-depth information on human interactions, relationships, and perspectives. As such, narratives have been used to understand people's experiences with pain and pain coping mechanisms-as well as to facilitate therapeutic outcomes. Furthermore, narrative research has shown that narration can help restore and promote relief, calm, hope, self-awareness, and self-understanding in chronic pain sufferers. Positive psychology interventions have been successful in improving the lives of people living with chronic pain, but these psychology interventions do not typically incorporate personal narratives. Still, narrative, and positive psychology scholarship foci overlap, as both aim to enhance people's quality of life, happiness, and well-being, and to promote the understanding of psychosocial strengths and resources. In this article, we provide a rationale for incorporating personal narratives as an agentic form of positive psychology intervention. To that aim, we outline areas of convergence between positive psychology and narrative research and show how combining positive psychology exercises and narration can have additive benefits for pain sufferers. We also show how integrating narration in positive psychology intervention research can have advantages for healthcare research and policy.

First impressions of a financial AI assistant: differences between high trust and low trust users

Calibrating appropriate trust of non-expert users in artificial intelligence (AI) systems is a challenging yet crucial task. To align subjective levels of trust with the objective trustworthiness of a system, users need information about its strengths and weaknesses. The specific explanations that help individuals avoid over- or under-trust may vary depending on their initial perceptions of the system. In an online study, 127 participants watched a video of a financial AI assistant with varying degrees of decision agency. They generated 358 spontaneous text descriptions of the system and completed standard questionnaires from the Trust in Automation and Technology Acceptance literature (including perceived system competence, understandability, human-likeness, uncanniness, intention of developers, intention to use, and trust). Comparisons between a high trust and a low trust user group revealed significant differences in both open-ended and closed-ended answers. While high trust users characterized the AI assistant as more useful, competent, understandable, and humanlike, low trust users highlighted the system's uncanniness and potential dangers. Manipulating the AI assistant's agency had no influence on trust or intention to use. These findings are relevant for effective communication about AI and trust calibration of users who differ in their initial levels of trust.

The Interplay Between Human Likeness and Agency on Virtual Influencer Credibility

This study investigated how human likeness (human-like vs. avatar-like) and agency (avatar vs. agent) interact to determine source credibility and the intention to interact with virtual influencers. The results revealed that human likeness significantly influenced three types of source credibility (attractiveness, trustworthiness, and expertise) and interaction intention. However, the agency of virtual influencers did not have a significant impact. Notably, the automated virtual influencer (i.e., the agent condition) was perceived to be more attractive and trustworthy and elicited higher interaction intention than the influencer operated by a human (i.e., the avatar condition). However, this relationship was observed only in the avatar-like condition. Thus, agency moderated the indirect relationship between human likeness and interaction through attractiveness and trustworthiness. Finally, the theoretical and practical implications of the findings and ideas for future research are discussed.

Corollary discharge function in healthy controls: Evidence about self-speech and external speech processing

As we speak, corollary discharge mechanisms suppress the auditory conscious perception of the self-generated voice in healthy subjects. This suppression has been associated with the attenuation of the auditory N1 component. To analyse this corollary discharge phenomenon (agency and ownership), we registered the event-related potentials of 42 healthy subjects. The N1 and P2 components were elicited by spoken vowels (talk condition; agency), by played-back vowels recorded with their own voice (listen-self condition; ownership) and by played-back vowels recorded with an external voice (listen-other condition). The N1 amplitude elicited by the talk condition was smaller compared with the listen-self and listen-other conditions. There were no amplitude differences in N1 between listen-self and listen-other conditions. The P2 component did not show differences between conditions. Additionally, a peak latency analysis of N1 and P2 components between the three conditions showed no differences. These findings corroborate previous results showing that the corollary discharge mechanisms dampen sensory responses to self-generated speech (agency experience) and provide new neurophysiological evidence about the similarities in the processing of played-back vowels with our own voice (ownership experience) and with an external voice.

Meaning from movement and stillness: Signatures of coordination dynamics reveal infant agency

How do human beings make sense of their relation to the world and realize their ability to effect change? Applying modern concepts and methods of coordination dynamics, we demonstrate that patterns of movement and coordination in 3 to 4-mo-olds may be used to identify states and behavioral phenotypes of emergent agency. By means of a complete coordinative analysis of baby and mobile motion and their interaction, we show that the emergence of agency can take the form of a punctuated self-organizing process, with meaning found both in movement and stillness.

Situating physiology within evolutionary theory

Traditionally defined as the science of the living, or as the field that beyond anatomical structure and bodily form studies functional organization and behaviour, physiology has long been excluded from evolutionary research. The main reason for this exclusion is that physiology has a presential and futuristic outlook on life, while evolutionary theory is traditionally defined as the study of natural history. In this paper, I re-evaluate these classic science divisions and situate physiology within the history of the evolutionary sciences, as well as within debates on the Extended Evolutionary Synthesis and the need for a Third Way of Evolution. I then briefly point out how evolutionary physiology in particular contributes to research on function, causation, teleonomy, agency and cognition.

Reconsidering a Global Agency for Medical Education: Back to the Drawing Board?

Issue: The World Federation for Medical Education (WFME) was established in 1972 and in the five decades that followed, has been the de facto global agency for medical education. Despite this apparently formidable remit, it has received little analysis in the academic literature. Evidence: In this article, we examine the historical context at the time WFME was established and summarize the key decisions it has taken in its history to date, highlighting particularly how it has adopted positions and programmes that have seemingly given precedence to the values and priorities of countries in the Global North. In doing so, we challenge the inevitability of the path that it has taken and consider other possible avenues that such a global agency in medical education could have taken, including to advocate for, and to develop policies that would support countries in the Global South. Implications: This article proposes a more democratic and equitable means by which a global organization for medical education might choose its priority areas, and a more inclusive method by which it could engage the medical education community worldwide. It concludes by hypothesizing about the future of global representation and priority-setting, and outlines a series of principles that could form the basis for a reimagined agency that would have the potential to become a force for empowerment and global justice in medical education.