The counseling process involves attention, emotional perception, cognitive appraisal, and decision-making. This study aimed to investigate cognitive appraisal and the associated emotional processes when reading short therapists' statements of motivational interviewing (MI). Thirty participants with work injuries were classified into the pre-contemplation (PC,n= 15) or readiness stage of the change group (RD,n= 15). The participants viewed MI congruent (MI-C), MI incongruent (MI-INC), or control phrases during which their electroencephalograms were captured. The results indicated significant Group × Condition effects in the (...) frontally oriented late positive complex (P600/LPC). The P600/LPC's amplitudes were more positive-going in the PC than in the RD group for the MI congruent statements. Within the PC group, the amplitudes of the N400 were significantly correlated (r= 0.607–0.649) with the participants' level of negative affect. Our findings suggest that the brief contents of MI statements alone can elicit late cognitive and emotional appraisal processes beyond semantic processing. (shrink)

Systematic study of the intersection of ethics consultation services and solid organ transplants and recipients can identify and illustrate ethical issues that arise in the clinical care of these patients, including challenges beyond resource allocation. This was a single-centre, retrospective cohort study of all adult ethics consultations between January 1, 2007, and December 31, 2017, at a large academic medical centre in the north-eastern United States. Of the 880 ethics consultations, sixty (6.8 per cent ) involved solid organ transplant, thirty-nine (...) (65.0 per cent) for candidates and twenty-one (35.0 per cent ) for recipients. Ethics consultations were requested for 4.3 per cent of heart, 4.9 per cent of lung, 0.3 per cent of liver, and 0.3 per cent of kidney transplant recipients over the study period. Nurses were more likely to request ethics consultations for recipients than physicians (80.0 per cent vs 20.0 per cent, p = 0.006). The most common reason for consultation among transplant candidates was discussion about intensity of treatment or goals of care after the patient was not or was no longer a transplant candidate. The most common reason for ethics consultation among transplant recipients was disagreement between transplant providers and patients/families/non-transplant healthcare professionals over the appropriate intensity of treatment for recipients. Very few consultations involved questions about appropriate resource allocation. Ethics consultants involved in these cases most often navigated communication challenges between transplant and non-transplant healthcare professionals and patients and families. (shrink)

Critical care society guidelines recommend that ethics committees mediate intractable conflict over potentially inappropriate treatment, including Do Not Resuscitate status. There are, however, limited data on cases and circumstances in which ethics consultants recommend not offering cardiopulmonary resuscitation despite patient or surrogate requests and whether physicians follow these recommendations. This was a retrospective cohort of all adult patients at a large academic medical center for whom an ethics consult was requested for disagreement over DNR status. Patient demographic predictors of ethics (...) consult outcomes were analyzed. In 42 of the 116 cases, the patient or surrogate agreed to the clinician recommended DNR order following ethics consultation. In 72 of 74 of the remaining cases, ethics consultants recommended not offering CPR. Physicians went on to write a DNR order without patient/surrogate consent in 57 of those cases. There were no significant differences in age, race/ethnicity, country of origin, or functional status between patients where a DNR order was and was not placed without consent. Physicians were more likely to place a DNR order for patients believed to be imminently dying. The median time from DNR order to death was 4 days with a 90-day mortality of 88.2%. In this single-center cohort study, there was no evidence that patient demographic factors affected ethics consultants’ recommendation to withhold CPR despite patient/surrogate requests. Physicians were most likely to place a DNR order without consent for imminently dying patients. (shrink)

In 2015, the major critical care societies issued guidelines outlining a procedural approach to resolving intractable conflict between healthcare professionals and surrogates over life-sustaining treatments (LST). We report our experience with a resolving conflict procedure. This was a retrospective, single-centre cohort study of ethics consultations involving intractable conflict over LST. The resolving conflict process was initiated eleven times for ten patients over 2,015 ethics consultations from 2000 to 2020. In all cases, the ethics committee recommended withdrawal of the contested LST. (...) In seven cases, the patient died or was transferred or a legal injunction was obtained before completion of the process. In the four cases in which LST was withdrawn, the time from ethics consultation to withdrawal of LST was 24.8 ± 12.2 days. Healthcare provider and surrogate were often distressed during the process, sometimes resulting in escalation of conflict and legal action. In some cases, however, surrogates appeared relieved that they did not have to make the final decision regarding LST. Challenges regarding implementation included the time needed for process completion and limited usefulness in emergent situations. Although it is feasible to implement a due process approach to conflict over LST, there are factors that limit the procedure’s usefulness. (shrink)

We describe the structure, operation, and experience of the Massachusetts General Hospital ethics committee, formally called the Edwin H. Cassem Optimum Care Committee, from January 2007 through December 2013. Founded in 1974 as one of the nation’s first hospital ethics committees, this committee has primarily focused on the optimum use of life-sustaining treatments. We outline specific sociodemographic and clinical characteristics of consult patients during this period, demographic differences between the adult inpatient population and patients for whom the ethics committee was (...) consulted, and salient features of the consults themselves. We include three case studies that illustrate important consult themes during this period. Our findings expand knowledge about the structure and workings of hospital ethics committees and illustrate how one ethics committee has developed and utilized policies on end-of-life care. More generally, we model a sociological approach to the study of clinical ethics consultation that could be utilized to contextualize institutional practices over time. (shrink)

INTRODUCTION TO ASPECTS OF FACE PROCESSING: TEN QUESTIONS IN NEED OF ANSWERS. HD Ellis 1. INTRODUCTION These proceedings of the first international ...

Design patterns are generalized solutions to frequently recurring problems. They were initially developed by architects and computer scientists to create a higher level of abstraction for their designs. Here, we extend these concepts to cell biology to lend a new perspective on the evolved designs of cells' underlying reaction networks. We present a catalog of 21 design patterns divided into three categories: creational patterns describe processes that build the cell, structural patterns describe the layouts of reaction networks, and behavioral patterns (...) describe reaction network function. Applying this pattern language to the E. coli central metabolic reaction network, the yeast pheromone response signaling network, and other examples lends new insights into these systems. (shrink)

The origin of marine invertebrate larvae has been an area of controversy in developmental evolution for over a century. Here, we address the question of whether a pelagic “larval” or benthic “adult” morphology originated first in metazoan lineages by testing the hypothesis that particular gene co-option patterns will be associated with the origin of feeding, indirect developing larval forms. Empirical evidence bearing on this hypothesis is derivable from gene expression studies of the sea urchin larval gut of two closely related (...) but differently developing congenerics, Heliocidaris tuberculata (feeding indirect-developing larva) and H. erythrogramma (nonfeeding direct developer), given two subsidiary hypotheses. (1) If larval gut gene expression in H. tuberculata was co-opted from an ancestral adult expression pattern, then the gut expression pattern will remain in adult H. erythrogramma despite its direct development. (2) Genes expressed in the larval gut of H. tuberculata will not have a coordinated expression pattern in H. erythrogramma larvae due to loss of a functional gut. Five structural genes expressed in the invaginating archenteron of H. tuberculata during gastrulation exhibit substantially different expression patterns in H. erythrogramma with only one remaining endoderm specific. Expression of these genes in the adult of H. erythrogramma and larval gut of H. tuberculata, but not in H. erythrogramma larval endoderm, supports the hypothesis that they first played roles in the formation of adult structures and were subsequently recruited into larval ontogeny during the origin and evolution of feeding planktotrophic deuterostome larvae. (shrink)

De Dreu and Gross's distinction between attack and defense is complicated in real-world conflicts because competing leaders construe their position as one of defense, and power imbalances place status quo challengers in a defensive position. Their account of defense as vigilant avoidance is incomplete because it avoids a reference to anger which transforms anxious avoidance into collective and unified action.

Strangers to Nature brings together many of the leading scholars who are working to redefine and expand the discourse on animal ethics. This volume will engage both scholars and lay-people by revealing the breadth of theorizing about the human/non-human animal relationship that is currently taking place.

This is the first book to offer the best essays, articles, and speeches on ethics and intelligence that demonstrate the complex moral dilemmas in intelligence collection, analysis, and operations. Some are recently declassified and never before published, and all are written by authors whose backgrounds are as varied as their insights, including Robert M. Gates, former Director of the Central Intelligence Agency; John P. Langan, the Joseph Cardinal Bernardin Professor of Catholic Social Thought at the Kennedy Institute of Ethics, Georgetown (...) University; and Loch K. Johnson, Regents Professor of Political Science at the University of Georgia and recipient of the Owens Award for contributions to the understanding of U.S. intelligence activities. Creating the foundation for the study of ethics and intelligence by filling in the gap between warfare and philosophy, this is a valuable collection of literature for building an ethical code that is not dependent on any specific agency, department, or country. (shrink)

For the successful achievement of evidence-based practice, clinicians, managers and purchasers need evidence on whether a particular intervention works and ways to judge the appropriateness of the outcome criteria and measures used. Guidance is needed on what outcome measure to use, especially within routine clinical care settings. Beginning with a re-clarification of the difference between a health status and an outcome measure, the paper presents an evaluative checklist for use by clinical audit and research staff to review outcome measures for (...) use in routine care settings. Central features include the user-centredness of the measure, its psychometric properties, feasibility of use and utility. The applicability of the checklist is illustrated for outcome measurement in diabetes and stroke care. A modified form of the checklist is proposed for use by the busy clinician as an aid to the critical review of research papers within the context of evidence-based practice and to aid health care practitioners' choice of which outcome measure(s) to use within routine clinical care. (shrink)

ObjectivesDuring their lifetimes, a majority of musicians experience playing-related musculoskeletal disorders. PRMD prevalence is tied to instrument choice, yet most studies examine heterogeneous groups of musicians, leaving some high-risk groups such as oboists understudied. This paper aims to ascertain the prevalence and nature of PRMDs in oboists, determine relevant risk factors, and evaluate the efficacy of treatment methods in preventing and remedying injuries in oboe players.MethodsA 10-question online questionnaire on PRMDs and their treatments was completed by 223 oboists. PRMDs were (...) compared across gender, weekly playing hours, career level, age, and years of playing experience.ResultsOf all respondents, 74.9% reported having had at least one PRMD in their lifetime. A majority of these injuries were of moderate to extreme severity. Females reported significantly more severe injuries than males. No significant effects of career level, age, or years of playing experience were observed. We found significant non-linear relationships between weekly playing hours and PRMD prevalence and severity. Injuries were most commonly on the right side of the body, with the right thumb, wrist, hand, and forearm being most affected in frequency and severity. Of those injuries for which recovery information was provided, only 26.1% of injuries were “completely recovered.” The perceived effectiveness of a few treatments tended to be ranked more highly than others.ConclusionThe oboists in this study experienced high rates of PRMD, particularly in the right upper extremities. Females and those playing 7-9 and 16-18 h per week reported a significantly higher severity of injuries than other groups. (shrink)

Advance care planning allows patients to articulate preferences for their medical treatment, lifestyle, and surrogate decision-makers in order to anticipate and mitigate their potential loss of decision-making capacity. Written advance directives are often emphasized in this regard. While these directives contain important information, there are several barriers to consider: veracity and accuracy of surrogate decision-makers in making choices consistent with the substituted judgement standard, state-to-state variability in regulations, literacy issues, lack of access to legal resources, lack of understanding of medical (...) options, and cultural disparities. Given these issues, it is vital to increase the use of patient and healthcare provider conversations as an advance care planning tool and to increase integration of such discourse into advance care planning policy as adjuncts and complements to written advance directives. This paper reviews current legislation about written advance directives and dissects how documentation of spoken interactions might be integrated and considered. We discuss specific institutional policy changes required to facilitate implementation. Finally, we explore the ethical issues surrounding the increased usage and recognition of clinician–patient conversations in advance care planning. (shrink)

Both short and long-term video-game play may result in superior performance on visual and attentional tasks. To further these findings, we compared the performance of experienced male video-game players (VGPs) and non-VGPs on a Simon-task. Experienced-VGPs began playing before the age of 10, had a minimum of 8 years of experience and a minimum play time of over 20 h per week over the past 6 months. Our results reveal a significantly reduced Simon-effect in experienced-VGPs relative to non-VGPs. However, this (...) was true only for the right-responses, which typically show a greater Simon-effect than left-responses. In addition, experienced-VGPs demonstrated significantly quicker reaction times and more balanced left-versus-right-hand performance than non-VGPs. Our results suggest that experienced-VGPs can resolve response-selection conflicts more rapidly for right-responses than non-VGPs, and this may in part be underpinned by improved bimanual motor control. (shrink)

Thomas Jefferson and Philosophy: Essays on the Philosophical Cast of Jefferson’s Writings is a collection of essays on topics that relate to philosophical aspects of Jefferson’s thinking over the years. Much historical insight is given to ground the various philosophical strands in Jefferson’s thought and writing on topics such as political philosophy, moral philosophy, slavery, republicanism, wall of separation, liberty, educational philosophy, and architecture.

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

This book celebrates the work of Patricia Werhane, an iconic figure in business ethics. This festschrift is a collection of articles that build on Werhane’s contributions to business ethics in such areas as Employee Rights, the Legacy of Adam Smith, Moral Imagination, Women in Business, the development of the field of business ethics, and her contributions to such fields as Health Care, Education, Teaching, and Philosophy. All papers are new contributions to the management literature written by well-known business ethicists, such (...) as Norman Bowie, Richard De George, Ronald Duska, Edwin Hartman, Michael Hoffman, Mollie Painter-Morland, Mark Schwartz, Andrew Wicks, and others. The volume is comprised of articles that reflect on Werhane’s work as well as build on it as a way to advance further research. At the end of the festschrift, Pat Werhane provides responses to each chapter. The first chapter of the book also includes the overview of Patricia Werhane’s work and her academic career. The book is written to appeal to management scholars and graduate students interested in the areas of Business Ethics, Modern Capitalism, and Human Rights. Patricia Werhane is one of the most distinguished figures in the field of business ethics. She was a founder of the field, she is one of its leading scholars, and she has had a profound impact on the world of business practice. Among her many accomplishments, Pat is known for her original work on moral imagination, she is an acclaimed authority on employee rights in the workplace, and she is one of the leading scholars on Adam Smith. Having been active in Academia for over 50 years, Werhane is a prolific author of over a hundred articles and book chapters, and the author or editor of twenty-seven books, including Adam Smith and his Legacy for Modern Capitalism, Moral Imagination and Management Decision-Making, and co-authored books Organization Ethics in Health Care, Alleviating Poverty Through Profitable Partnerships, Obstacles to Ethical Decision-Making, Corporate Responsibility: The American Experience, and Research Approaches to Business Ethics and Corporate Responsibility. (shrink)

While a significant literature has appeared discussing theoretical ethical concerns regarding COVID-19, particularly regarding resource prioritization, as well as a number of personal reflections on providing patient care during the early stages of the pandemic, systematic analysis of the actual ethical issues involving patient care during this time is limited. This single-center retrospective cohort mixed methods study of ethics consultations during the first surge of the COVID 19 pandemic in Massachusetts between March 15, 2020 through June 15, 2020 aim to (...) fill this gap. Results indicate that there was no significant difference in the median number of monthly consultation cases during the first COVID-19 surge compared to the same period the year prior and that the characteristics of the ethics consults during the COVID-19 surge and same period the year prior were also similar. Through inductive analysis, we identified four themes related to ethics consults during the first COVID-19 surge including (1) prognostic difficulty for COVID-19 positive patients, (2) challenges related to visitor restrictions, (3) end of life scenarios, and (4) family members who were also positive for COVID-19. Cases were complex and often aligned with multiple themes. These patient case-related sources of ethical issues were managed against the backdrop of intense systemic ethical issues and a near lockdown of daily life. Healthcare ethics consultants can learn from this experience to enhance training to be ready for future disasters. (shrink)

In this historical contribution, we assess Duns Scotus’s analysis of atonement (Commentary on the Sentences bk. III). We also include a partial exploration of his analysis of penance (Sentences bk. IV), because certain topics which we tend to discuss within atonement-theory, for example the analysis of the virtue of punishment, pertained to the subject of penance for Scotus. In recent scholarship, Andrew Rosato has argued that Scotus adapted the Anselmian non-penal view of Christ’s substitutionary satisfaction to the penal understanding (...) of satisfaction operative in penance. In this contribution, however, we argue that Scotus’s understanding remained non-penal: his view of the atonement depends on meritorious supererogatory acts of love. Additionally, we harvest some valuable Scotistic insights for atonement-theory, some of them applicable to penal theories as well. (shrink)

Introduction: the age of reflexion Part I. Romanticism: 1. Romanticism and the sciences David Knight 2. Schelling and the origins of his Naturphilosophie S. R. Morgan 3. Romantic philosophy and the organization of the disciplines: the founding of the Humboldt University of Berlin Elinor S. Shaffer 4. Historical consciousness in the German Romantic Naturforschung Dietrich Von Engelhardt 5. Theology and the sciences in the German Romantic period Frederick Gregory 6. Genius in Romantic natural philosophy Simon Shaffer Part II. Sciences of (...) the Organic: 7. Doctors contra clysters and feudalism: the consequences of a Romantic revolution Nelly Tsouyopoulos 8. Morphotypes and the historical-genetic method in Romantic biology Timothy Lenoir 9. ’Metaphorical mystifications’: the Romantic gestation of nature in British biology Evelleen Richards 10. Transcendental anatomy Philip F. Rehbock 11. Romantic thought and the origins of cell theory L. S. Jacyna 12. Alexander von Humbolt and the geography of vegetation Malcolm Nicholson Part III. Sciences of the Inorganic: 13. Goethe, colour, and the science of seeing Dennis L. Sepper 14. Johann Wilhelm Ritter: Romantic physics in Germany Walter D. Wetzels 15. The power and the glory: Humphrey Davy and Romanticism Christopher Lawrence 16. Oersted’s discovery of electromagnetism H. A. M. Snelders 17. Caves, fossils and the history of the earth Nicholas A. Rupke Part IV. Literature and the Sciences: 18. Goethe’s use of chemical theory in his Elective Affinities Jeremy Adler 19. Kleist’s bedlam: abnormal psychology and psychiatry in the works of Heinrich von Kleist Nigel Reeves 20. Coleridge and the sciences Trevor H. Levere 21. Nature’s book: the language of science in the American Renaissance David van Leer 22. The shattered whole: Georg Buchner and Naturphilosophie John Reddick. (shrink)

We work in λH, the untyped λ-calculus in which all unsolvables are identified. We resolve a conjecture of Barendregt asserting that the range of a definable map is either infinite or a singleton. This is refuted by constructing a λ-term Ξ such that ΞM = ΞΙ ⟺ ΞM ≠ ΞΩ. The construction generalizes to ranges of any finite size, and to some other sensible lambda theories.

The Perfect Guide to the Sciences of the Qurʾān, by Imām Jalāl-al-Dīn ʿAbd al-Raḥmān al-Suyūṭī, vol. 1. Translated by Ḥamid Algar, Michael Schub, and Ayman Abdel Ḥaleem; reviewed by Osman S. A. Ismaʿīl A. al-Bīlī. The Great Books of Islamic Civilization. Reading, UK: Garnett Publishing, 2011. Pp. xxxiii + 301. £60.

The main thrust of my argument was that ad hoc su gge s ti ons of ch a ri ty cannot replace a systematic and theoreti c a lly inform ed approach to poverty rel i ef . Ch a ri t a ble don a ti on som eti m e s h elps—and som etimes harm s — but is no general solution to global poverty, and can be po s i tively dangerous wh en pre s en (...) ted as such. We need to consider, and often choose, other routes to helping the poor—including ethical to u rism and fair trade in lu x u ry goods. We will not be able to invest in such feasible routes if we give away all our extra income, as Singer recommends. Sticking to donation above all, when a combination of other strategies is necessary, is highly likely to harm the poor. Si n ger doe s n’t re a lly en ga ge my argumen t . In s te ad , he cari c a tu res our “f u n d a m ental disa greem en t” :a pp a ren t ly, Si n ger rej ects va ri o u s policies because he takes into account the “f act s” ; wh ereas Ku per is the one seeking a “f a i t h ,” a “po l i tical ph i l o s ophy. . . i m mune to ref ut a ti on on the basis of evi den ce .” Anyon e who has re ad my arti cle (pp. 1 07 - 2 0) must fin d this puzzling. The arti cle explains at len g t h wh i ch kinds of b ack ground theories help us to d i s cern and re s pon s i bly con s i der the rel eva n t f act s . I show that Si n ger sel ects and uses fact s u n c ri ti c a lly prec i s ely because he has no po l i tical econ omy, no po l i tical soc i o l ogy, and no t h eory of ju s ti ce . We are seri o u s ly misled if we do not draw adequ a tely on the wi s dom and.. (shrink)

De Poolse componist Górecki schreef Beatus Vir in opdracht van kardinaal Wojtyła – de latere paus Johannes Paulus II – en verergerde daarmee het conflict dat hij als rector van een belangrijke muziekacademie had met de communistische machthebbers. Uit het stuk, dat de weerslag vormt van dat conflict, spreken een zeldzame kracht, schoonheid en emotie.

We develop a new puzzle concerning a material being's relationship to the smallest parts of the material world. In particular, we investigate how a being could be responsible for anything if its be...