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The neurological and physiological basis of brain function and disease has been a significant focus of investigation throughout the history of medical research. Recent advances in understanding have led to the development of new treatments for diseases of the brain and defects of cognitive and behavioral function: pharmacological, cell-based and even gene therapy may all provide keys to cognitive regeneration. Such therapies, however, might be applied not only towards restoring brain function in the case of disease but to enhance cognitive function for healthy individuals. The concept of cognitive enhancement raises many ethical issues: whether brain-enhancing treatments should be developed and made available and to whom; and what potential consequences might arise? This paper explores some of the ethical arguments associated with cognitive enhancement and concludes that although the technology involved is as yet uncertain and issues of social equity remain to be addressed, the potential benefit of enhancing human brain function is clear.

Introduction: End‐stage renal disease (ESRD) has been associated with a range of cognitive deficits, including impaired retrospective memory and attention. Prospective memory (PM) is memory for future intentions, such as remembering to take medication on time. Prospective memory has not been examined in any ESRD patients; yet, the implications upon diet and medication management could potentially have detrimental effects on patient welfare. This is the first study to examine PM in ESRD patients being treated with hemodialysis (HD). Methods: Hemodialysis patients (n = 18) were compared with age‐matched and education‐matched controls (n = 18) on a boardgame task that emulates a typical week of activities (i.e., grocery shopping, meetings with friends), requiring the participant to remember a series of upcoming tasks. Other measures were also examined, including general cognitive decline, measures of independent living, IQ, and mood. Findings: Patients recalled significantly fewer upcoming events than the control group, suggesting an impairment of PM. No significant relationship was found between PM performance and any other measures, suggesting the difference between groups is likely due to the effects of ESRD, HD treatment, or some associated comorbidity. Discussion: This is the first study to demonstrate a PM deficit in patients undergoing HD treatment. This finding contributes to the current knowledge of the cognitive profile of patients undergoing HD while also highlighting the implications that a PM deficit may have on patient quality of life. The finding may go some way to explaining variances in patients' ability to monitor and adhere to medication and dietary regimes and, ultimately, to live independently. The study also highlights the necessity of viewing treatment for ESRD as a holistic process to maximize patient well‐being. [ABSTRACT FROM AUTHOR]

Aims and objectives While haemodialysis is an effective treatment for end-stage renal disease, the requirements and restrictions it imposes on patients can be onerous. The aim of this study was to obtain UK National Health Service patients' perspectives on the challenges arising from haemodialysis with the intention of identifying potential improvements. Background Depression rates are particularly high in those with end-stage renal disease; however, there is limited insight into the range of stressors associated with haemodialysis treatment within the National Health Service contributing to such high rates, particularly those of a cognitive or psychological nature. Design A qualitative approach was used to obtain rich, patient-focused data; one-to-one semi-structured interviews were conducted with twenty end-stage renal disease at a UK National Health Service centre. Methods Patients were interviewed during a typical haemodialysis session. Thematic analysis was used to systematically interpret the data. Codes were created in an inductive and cyclical process using a constant comparative approach. Results Three themes emerged from the data: (i) fluctuations in cognitive/physical well-being across the haemodialysis cycle, (ii) restrictions arising from the haemodialysis treatment schedule, (iii) emotional impact of haemodialysis on the self and others. The findings are limited to predominantly white, older patients (median = 74 years) within a National Health Service setting. Conclusions Several of the experiences reported by patients as challenging and distressing have so far been overlooked in the literature. A holistic-based approach to treatment, acknowledging all aspects of a patient's well-being, is essential if optimal quality of life is to be achieved by healthcare providers. Relevance to clinical practice The findings can be used to inform future interventions and guidelines aimed at improving patients' treatment adherence and outcomes, for example, improved reliable access to mental health specialists. [ABSTRACT FROM AUTHOR]

Objectives To determine the difference in receipt of activity of daily living ( ADL) assistance between obese and normal-weight older adults. Design Retrospective cohort study. Setting National Health and Aging Trends Study, 2011-2015. Participants U.S. adults aged 65 and older with ADL disability and a body mass index ( BMI) of 18.5 kg/m2 or greater (N = 5,612) Measurements BMI was classified as normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), or obese (≥30.0 kg/m2). Primary outcome was self-reported receipt of help with specific ADLs. Models were adjusted for demographic characteristics (age, sex, race), degree of need (self-reported general health, severity of disability), household resources (income, marriage, people in household, number of children), and cognitive status (dementia, proxy respondent). Results Obese with disabilities had lower rates of receiving assistance with walking inside (odds ratio ( OR) = 0.63, 95% confidence interval ( CI) = 0.50-0.81), walking outside ( OR = 0.76, 95% CI = 0.59-0.97), toileting ( OR = 0.68, 95% CI = 0.52-0.89), and getting in and out of bed ( OR = 0.67, 95% CI = 0.50-0.87) than normal-weight older adults after adjustment for respondent demographic characteristics. Level of need and cognitive status partially explained the associations. In fully adjusted models, older adults with obesity still had significantly lower odds of receiving assistance in getting in and out of bed than normal weight adults ( OR = 0.69, 95% CI = 0.49-0.98). Conclusion Older adults with obesity are less likely to receive assistance for ADL disabilities than their normal-weight counterparts-an important concern because of ongoing demographic changes in the United States. [ABSTRACT FROM AUTHOR]

The article presents an edited transcript of a debate on moral enhancement between John Harris and Julian Savulescu during the "Enhancement: Cognitive, Moral and Mood" conference held at the University of Belgrade in Serbia. Topics discussed include morality's ability to keep up with scientific change and if not, whether it should be compulsory, Harris' skepticism about moral enhancement's value and methodologies, and how to bridge the gap between what people see to be right and how people act.

This article explores the consequences of interventions to secure moral enhancement that are at once compulsory and inescapable and of which the subject will be totally unaware. These are encapsulated in an arresting example used by Ingmar Perrson and Julian Savulescu concerning a “God machine” capable of achieving at least three of these four objectives. This article demonstrates that the first objective—namely, moral enhancement—is impossible to achieve by these means and that the remaining three are neither moral nor enhancements nor remotely desirable. Along the way the nature of morality properly so called is further explored.

This paper identifies human enhancement as one of the most significant areas of bioethical interest in the last twenty years. It discusses in more detail one area, namely moral enhancement, which is generating significant contemporary interest. The author argues that so far from being susceptible to new forms of high tech manipulation, either genetic, chemical, surgical or neurological, the only reliable methods of moral enhancement, either now or for the foreseeable future, are either those that have been in human and animal use for millennia, namely socialization, education and parental supervision or those high tech methods that are general in their application. By that is meant those forms of cognitive enhancement that operate across a wide range of cognitive abilities and do not target specifically 'ethical' capacities. The paper analyses the work of some of the leading contemporary advocates of moral enhancement and finds that in so far as they identify moral qualities or moral emotions for enhancement they have little prospect of success. [ABSTRACT FROM AUTHOR]

The role of so-called critical features in the perception of ambiguous figures was examined in two experiments. In the first, selective removal of certain features was found to bias the initial perception of the wife mother-in-law figure. In the second, the position of the fixation point was found to influence the dominance of aspect of the wife mother-in- law figure. During an extended viewing period, when the fixation point was close to a critical feature (as defined in the first experiment), the tendency was for the figure to be less ambiguous, and for large figures to be less ambiguous than small. The effects are discussed with reference to the hypothesis that changes of visual attention between different features underlie the perceptual alternations of the figure. [ABSTRACT FROM AUTHOR]

It is proposed that happiness be classified as a psychiatric disorder and be included in future editions of the major diagnostic manuals under the new name: major affective disorder, pleasant type. In a review of the relevant literature it is shown that happiness is statistically abnormal, consists of a discrete cluster of symptoms, is associated with a range of cognitive abnormalities, and probably reflects the abnormal functioning of the central nervous system. One possible objection to this proposal remains — that happiness is not negatively valued. However, this objection is dismissed as scientifically irrelevant. [ABSTRACT FROM AUTHOR]