Dr. Lantos is a leading voice in bioethics, having served as President of the American Society of Law, Medicine and Ethics, as well as the American Society of Bioethics and Humanities. In addition, Dr. Lantos worked on President Clinton’s health reform task force in 1993. In addition to extensive scholarly output, Dr. Lantos has also appeared on Larry King Live, Oprah, and Nightline.
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Working group meetings provide an opportunity for investigators to receive feedback on research proposals, drafts of papers, grant applications, or any other aspects of projects at any stage of development. This meeting is designed as an informal working group not a formal presentation. For more details look under the How We Can Help section.
To see the schedule for upcoming meetings please check the Events calendar. The next working group meeting is listed below.
Funded by Department of Health and Human Services - National Institutes of Health Subcontracts
Funding Years: 2014.
Promoting physical activity and decreasing sedentary behavior are key goals in the fight against cancers; physical activity is associated with lower risk of several cancers [1-10], and lower overall morbidity and mortality [11-26]. Thus, theory-driven initiatives to change these behaviors are essential [1-10, 26-40]. PQ#3 highlights the necessity for new perspectives on the interplay of cognitive and emotional factors in promoting behavior change. Current theories, which focus primarily on predictors derived from self-report measures, do not fully predict behavior change. For example, recent meta-analyses suggest that on average, variables from the Theory of Planned Behavior account for ~27% of the variance in behavior change [41, 42]. This limits our ability to design optimally effective interventions , and invites new methods that may explain additional variance. Our team has shown that neural activation in response to health messages in hypothesized neural regions of interest can double the explained variance in behavior change, above and beyond self-reports of attitudes, intentions, and self-efficacy [44, 45]. We now propose a next leap, inspired by PQ3, to identify how cognitive and affective processes interact in the brain to influence and predict behavior change. Our core hypothesis is that the balance of neural activity in regions associated with self-related processing versus defensive counterarguing is key in producing health behavior change, and that self-affirmation (an innovative approach, relatively new to the health behavior area ) can alter this balance. Self-affirmation theory  posits that people are motivated to maintain a sense of self-worth, and that threats to self-worth will be met with resistance, often i the form of counterarguing. One common threat to self-worth occurs when people are confronted with self-relevant health messages (e.g. encouraging less sedentary behavior in overweight, sedentary adults). This phenomenon speaks to a classic and problematic paradox: those at highest risk are likely to be most defensive and least open to altering cancer risk behaviors . A substantial, and surprisingly impressive, body of evidence demonstrates that affirmation of core-values (self-affirmation priming) preceding messages can reduce resistance and increase intervention effectiveness [46, 49-53]. Uncovering neural mechanisms of such affirmation effects , has transformative potential for intervention design and selection. To test our conceptual assumptions and core hypothesis we will: (1) Identify neural signals associated with processing health messages as self-relevant versus counterarguing; (2) Test whether self-affirmation alters the balance of these signals; (3) Use these neural signals to predict physical activity behavior change, above and beyond what is predicted by self-report measures alone. Our approach is innovative methodologically (using fMRI to understand and predict behavior change), and conceptually (self-affirmation may dramatically increase intervention effectiveness). Benchmarks will include objectively measured decreases in sedentary behavior in affirmed vs. control subjects (using accelerometers), and increases in predictive capacity afforded by neuroimaging methods, compared to self-report alone.
PI(s): Thad Polk
Co-I(s): Lawrence An, Sonya Dal Sin, Kenneth Resnicow, Victor Strecher
Reshma Jagsi, MD, DPhil
Title – "Ethical Issues Related to Fundraising from Grateful Patients"
Abstract: Health care institutions are becoming increasingly deliberate about philanthropic fundraising given the need to sustain their missions in the face of decreases in governmental research funds and lowering reimbursement for clinical care. Donations from grateful patients constitute 20% of all philanthropic contributions to academic medical centers, totaling nearly $1 billion a year in recent years. Institutions frequently employ development professionals to facilitate philanthropy. The development literature describes various approaches for identifying patients capable of contributing, cultivating potential donors, and engaging physicians in the solicitation of grateful patients, emphasizing that patients themselves may also benefit from exercising altruism in this way. However, little evidence exists to guide the ethical practice of grateful patient fundraising, and concerns exist regarding privacy and confidentiality, patient vulnerability, and physicians' conflicts of obligations in this context. Therefore, we will discuss how the process of philanthropic development should be structured in order to demonstrate respect for all persons involved, including patients who donate, those who might consider donation, those who do not wish to donate, and those who cannot afford to do so.
Lunch is provided. Please note: Lunch is first come, first served.
We are delighted to officially announce that Raymond De Vries will be joining Angie as the new Co-Director of the Center. Ray has been an active faculty member of CBSSM for several years. He is a Professor in the Departments of Medical Education, Obstetrics and Gynecology, and Sociology, as well as a visiting Professor at Maastricht University in the Netherlands. He is particularly interested in the regulation of science; clinical trials of genetic therapies and deep brain stimulation; international research ethics; and the social, ethical, and policy issues associated with maternity care.
Scott Kim recently stepped down from the Co-Directorship of CBSSM to take on a new position as Senior Investigator in the Department of Bioethics at the National Institutes of Health. He continues to assist with various CBSSM-related research projects.
It is our great pleasure to announce that CBSSM Research Fellow Kayte Spector-Bagdady has accepted a faculty position as a Research Investigator in the UMHS Department of Obstetrics and Gynecology, effective November 1, 2016.
In her time as a research fellow at CBSSM Kayte was awarded the 2016 Outstanding Postdoctoral Fellow Award, has been an active and valued member of the Adult and Pediatric Ethics Committees, the IRB advisory board, and has had an active publication and teaching program. Kayte will continue to be a part of CBSSM, leading our Program in Research Ethics.