Interest in home birth appears to be growing among American women, and most obstetricians can expect to encounter patients who are considering home birth. In 2011, the American College of Obstetricians and Gynecologists (ACOG) issued an opinion statement intended to guide obstetricians in responding to such patients.In this article, I examine the ACOG statement in light of the historical and contemporary clinical realities surrounding home birth in the United States, an examination guided in part by my own experiences as an (...) obstetrician in home-birth-friendly and homebirth-unfriendly medical milieus. Comparison with other guidelines indicates that ACOG treats home birth as an ethical exception: comparable evidence leads to strikingly different recommendations in the case of home birth and the case of trial of labor following a prior cesarean; and ACOG treats other controversial issues that involve similar ethical questions quite differently.By casting the provision of information as not just the primary but the sole ethical responsibility of the obstetrician, ACOG statement obviates obstetricians’ responsibilities to provide appropriate clinical care and to make the safest possible clinical environment for those mothers who choose home birth and for their newborns. What, on its face, seems to be a statement of respect for women’s autonomy, implicitly authorizes behaviors that unethically restrain truly autonomous choices. Obstetricians need not attend home births, I argue. Our ethical duties do, however, oblige us (1) to refer clients to skilled clinicians who will attend home birth, (2) to continue respectful antenatal care for those women choosing home birth, (3) to provide appropriate consultation to home birth attendants, and (4) to ensure that transfers of care are smooth and nonpunitive. (shrink)

Biographical essays explore the careers of two major early photographers, Joseph-Philibert Girault de Prangey and William James Stillman. in addition, portfolios with works by Maxime Du Camp, John Beasley Greene, Francis Frith, Robert Macpherson, Adolphe Braun and others testify to the strength and consistency of other early photographers who captured the antique worlds around the Mediterranean."--BOOK JACKET.

I thoroughly enjoyed Dr. Freedman’s paper on “Akratic Believing.” Often, philosophy of psychiatry offers insights to clarify psychological and psychiatric concepts. Less frequently, it involves a real dialogue between philosophy and psychological science. Dr. Freedman’s account of what is bothersome, rather than just philosophically wrong-headed, about the concept of epistemic akrasia demonstrates that, at least where anxiety is concerned, the a posteriori world may have a great deal to offer theoretical philosophy. Freedman argues that understanding somatic responses to trauma, or (...) more broadly construed, to anxiety, dissolves the problem of why there seems to be more to the problem of epistemic... (shrink)

Executive functions (EFs) and impulsivity are dimensions of self-regulation that are both related to psychopathology. However, self-report measures of impulsivity and laboratory EF tasks typically display small correlations, and existing research indicates that impulsivity and EFs may tap separate aspects of self-regulation that independently statistically predict psychopathology in adulthood. However, relationships between EFs, impulsivity, and psychopathology may be different in childhood compared to adulthood. Here, we examine whether these patterns hold in the baseline assessment of the Adolescent Brain and Cognitive (...) Development (ABCD) sample, a national sample of over 11,000 children (including 749 twin pairs) ages 9–10 years. We examine the phenotypic and genetic relationships among latent variables for different components of EFs and multiple facets of impulsivity. Additionally, we assess how EFs and impulsivity relate to composite measures and latent variables of psychopathology derived from parent report. EFs were weakly correlated with impulsivity, and the strength varied by impulsivity facet, emphasizing their separability. We did not identify significant genetic and environmental correlations between EFs and impulsivity. Moreover, controlling for their small relationships with each other, both EFs and some facets of impulsivity statistically predicted an Externalizing factor, attention problems, and social problems, and twin analyses suggested these relationships were genetic in origin. These findings indicate that EFs and impulsivity represent phenotypically and genetically separable aspects of self-regulation that are both transdiagnostic correlates of psychopathology in childhood. (shrink)

The mental health recovery movement promotes patient self-determination and opposes coercive psychiatric treatment. While it has made great strides towards these ends, its rhetoric impairs its political efficacy. We illustrate how psychiatry can share recovery values and yet appear to violate them. In certain criminal proceedings, for example, forensic psychiatrists routinely argue that persons with mental illness who have committed crimes are not full moral agents. Such arguments align with the recovery movement’s aim of providing appropriate treatment and services for (...) people with severe mental illness, but contradict its fundamental principle of self-determination. We suggest that this contradiction should be addressed with some urgency, and we recommend a multidisciplinary collaborative effort involving ethics, law, psychiatry, and social policy to address this and other ethical questions that arise as the United States strives to implement recovery-oriented programs. (shrink)

BackgroundDespite its ubiquity, it is often not clear what organizations and services mean by well-being. Visual impairment has been associated with poorer well-being and well-being has become a key outcome for support and services for adults living with VI. A shared understanding of what well-being means is therefore essential to enable assessment of well-being and cross-service provision of well-being support.ObjectivesTo provide an overview of the ways in which well-being has been conceptualized in research relating to adults living with VI.Eligibility criteriaArticles (...) were included in the review if the article discussed well-being in the context of adults living with VI, was available in English and as a full text.Data sourcesA systematic search using search terms relating to VI and well-being was conducted in EBSCOHost and Ovid.ChartingA team of three reviewers screened titles, abstracts and full-texts articles and extracted data. Ambiguous articles were referred to the research group and discussed.ResultsOf 10,662 articles identified in the search, 249 were included in the review. These referred to 38 types of well-being. The most common types were general well-being emotional well-being and psychological well-being. Most articles referred to one type only, with a maximum of 9 listed in one article. A large number of articles did not clearly define well-being. A wide range of indicators of well-being related to the domains of hedonia, mood, positive and negative affect, quality of life, mental health, eudaimonia, self/identity, health, psychological reactions to disability and health problems, functioning, social functioning and environment, were extracted, many of which were used just once.ConclusionsThere remains a lack of consensus on how well-being is conceptualized and assessed in the context of adult VI. A standardized multi-domain approach derived with input from adults with VI and practitioners working with them is required to enable comparison of findings and cross-organizational provision of support. (shrink)

Advances in DNA sequencing technology open new possibilities for public health genomics, especially in the form of general population preventive genomic sequencing. Such screening programs would sit at the intersection of public health and preventive health care, and thereby at once invite and resist the use of clinical ethics and public health ethics frameworks. Despite their differences, these ethics frameworks traditionally share a central concern for individual rights. We examine two putative individual rights—the right not to know, and the child’s (...) right to an open future—frequently invoked in discussions of predictive genetic testing, in order to explore their potential contribution to evaluating this new practice. Ultimately, we conclude that traditional clinical and public health ethics frameworks, and these two rights in particular, should be complemented by a social justice perspective in order adequately to characterize the ethical dimensions of general population PGS programs. (shrink)

Our purpose in this article is to identify and suggest resolution for two core problematics of grounded theory. First, while grounded theory provides transparency to one part of the conceptualization process, where codes emerge directly from the data, it provides no such systematic or transparent way for gaining insight into the conceptual relationships between discovered codes. Producing a grounded theory depends not only on the definition of conceptual pieces, but the delineation of a relationship between at least two of those (...) pieces. Second, the conceptualization process of grounded theory is done in hierarchical fashion, where individual codes emerge from the data but then are used to generate insight into more general concepts and thematic statements. But various works on grounded theory have failed to provide any systematic way of using data specific levels of scale (the codes) to gain insight into more macro levels of scale (concepts and themes). We offer fractal concept analysis as a means of resolving both of these issues. By using a logic structure generator, fractal concept analysis delineates self-similar conceptual frameworks at various levels of abstraction, yielding a method for linking concepts together within and between levels of scale encountered in the grounded theory coding and categorization process. We conclude that this fractal analytic technique can bolster the aims of grounded theory as a formalized and systematic process for generating theory from empirical data. (shrink)

Prompted by the development of the Theory of Challenge and Threat States in Athletes (Jones et al, 2009), recent years has witnessed a considerable increase in research examining challenge and threat in sport. This manuscript provides a critical review of the literature examining challenge and threat in sport, tracing its historical development and some of the current empirical ambiguities. In an attempt to reconcile some of these ambiguities, and utilising neurobiological evidence associated with approach- and avoidance-motivation (cf. Elliot & Covington, (...) 2001), this paper draws upon the Evaluative Space Model (ESM: Cacioppo et al., 1997) and considers the implications for understanding challenge and threat in sport. For example, rather than see challenge and threat as opposite ends of a single bipolar continuum, the ESM implies that individuals could be (1) challenged, (2) threatened, (3) challenged and threatened, or (4) neither challenged or threatened by a particular stimulus. From this perspective it could be argued that the appraisal of some sport situations as both challenging and threatening could be advantageous, whereas the current literature seems to imply that the appraisal of stress as a threat is maladaptive for performance. In drawing upon the ESM, we outline the Evaluative Space Approach to Challenge and Threat and provide several testable hypotheses for advancing understanding of challenge and threat (in sport). We also outline a number of cardiovascular and experiential measures that can be used to examine these hypotheses. In sum, this paper provides a significant theoretical, empirical and practical contribution to our understanding of challenge and threat (in sport). (shrink)

While bioethics as a field has concerned itself with methodological issues since the early years, there has been no systematic examination of how ethics is incorporated into research on the Ethical, Legal and Social Implications of the Human Genome Project. Yet ELSI research may bear a particular burden of investigating and substantiating its methods given public funding, an explicitly cross-disciplinary approach, and the perceived significance of adequate responsiveness to advances in genomics. We undertook a qualitative content analysis of a sample (...) of ELSI publications appearing between 2003 and 2008 with the aim of better understanding the methods, aims, and approaches to ethics that ELSI researchers employ. We found that the aims of ethics within ELSI are largely prescriptive and address multiple groups. We also found that the bioethics methods used in the ELSI literature are both diverse between publications and multiple within publications, but are usually not themselves discussed or employed as suggested by bioethics method proponents. Ethics in ELSI is also sometimes undistinguished from related inquiries. (shrink)

The Ontology for Biomedical Investigations (OBI) is an ontology that provides terms with precisely defined meanings to describe all aspects of how investigations in the biological and medical domains are conducted. OBI re-uses ontologies that provide a representation of biomedical knowledge from the Open Biological and Biomedical Ontologies (OBO) project and adds the ability to describe how this knowledge was derived. We here describe the state of OBI and several applications that are using it, such as adding semantic expressivity to (...) existing databases, building data entry forms, and enabling interoperability between knowledge resources. OBI covers all phases of the investigation process, such as planning, execution and reporting. It represents information and material entities that participate in these processes, as well as roles and functions. Prior to OBI, it was not possible to use a single internally consistent resource that could be applied to multiple types of experiments for these applications. OBI has made this possible by creating terms for entities involved in biological and medical investigations and by importing parts of other biomedical ontologies such as GO, Chemical Entities of Biological Interest (ChEBI) and Phenotype Attribute and Trait Ontology (PATO) without altering their meaning. OBI is being used in a wide range of projects covering genomics, multi-omics, immunology, and catalogs of services. OBI has also spawned other ontologies (Information Artifact Ontology) and methods for importing parts of ontologies (Minimum information to reference an external ontology term (MIREOT)). The OBI project is an open cross-disciplinary collaborative effort, encompassing multiple research communities from around the globe. To date, OBI has created 2366 classes and 40 relations along with textual and formal definitions. The OBI Consortium maintains a web resource providing details on the people, policies, and issues being addressed in association with OBI. (shrink)

Numerous researchers have investigated accounting students’ levels of moral reasoning, ethical choice and judgment employing the Defining Issues Test and using its P score as an indicator of moral reasoning. Not surprisingly, a number of DIT studies report conflicting results. Moreover, despite widespread use of the DIT, there is concern that it may not adequately measure all facets of ethical judgment :1–26, 2010). Thus, we endeavor to provide insight not only into the contradictory results but also about the applicability of (...) the DIT for studying accounting students. To do so, we collect published and unpublished DIT studies employing accounting students as subjects and use meta-analysis to aggregate findings across these studies to quantify their results, examining commonly employed variables. We show significant relationships between P scores and some variables but not others. Further, our findings demonstrate that the DIT provides added insights when exploring questions of ethical choice, and ethics instruction, particularly when the instruction is embedded in an accounting course. Finally, we find that the level of DIT P scores reported in the studies relates to whether the study was published. We discuss the implications of our findings for future research. (shrink)

L'actuel regain d'intérêt pour la philosophie témoigne de l'attente la plus légitime qui soit, eu égard aux prétentions traditionnelles et à l'aura de cette discipline, mais également la plus difficile à satisfaire : qu'elle mène celui qui épouse ses chemins à une véritable réappropriation de sa propre existence, à une recréation personnelle. Impossible ici de se satisfaire d'un horizon de consolations aimables et de recettes de prospérité, non plus que de vertiges théorisants ou d'érudition monomaniaque. Face à un monde qui (...) semble avoir d'avance consumé nos élans et consommé nos révoltes, les postures et commodités ne sont plus de mise. Un retour d'authenticité s'impose à l'engagement philosophique lui-même. En fait, la mise à l'épreuve de soi est passage obligé, dès lors que de mort de Dieu en chute des idoles de remplacement, nul ne peut plus prétendre faire surgir la valeur irréductible de l'humain d'ailleurs que de l'homme... D'où la pertinence et l'attrait de l'exploration, ici proposée, des voies traditionnelles et ressorts nouveaux d'une maïeutique propre à faire naître l'homme à lui-même, à travers la mise à nu et le retrait de tous les masques que nous imposent la vie en société et le respect de ses codes. Poussant au déracinement du moi comme à une étape nécessaire au dévoilement de notre vérité, les auteurs de cet essai s'inscrivent dans la lointaine filiation de ces philosophes de l'Antiquité (Stoïciens, Cyniques) qui vivaient leur philosophie comme un travail sur soi, voire une ascèse, et dans le prolongement de tout ce pan de la pensée contemporaine qui, avec Foucault notamment, s'est employé à armer la philosophie d'un pouvoir maximal de transformation croisée de celui qui s'y adonne et du social qui l'environne. (shrink)

The scientific study of consciousness emerged as an organized field of research only a few decades ago. As empirical results have begun to enhance our understanding of consciousness, it is important to find out whether other factors, such as funding for consciousness research and status of consciousness scientists, provide a suitable environment for the field to grow and develop sustainably. We conducted an online survey on people’s views regarding various aspects of the scientific study of consciousness as a field of (...) research. 249 participants completed the survey, among which 80% were in academia, and around 40% were experts in consciousness research. Topics covered include the progress made by the field, funding for consciousness research, job opportunities for consciousness researchers, and the scientific rigor of the work done by researchers in the field. The majority of respondents (78%) indicated that scientific research on consciousness has been making progress. However, most participants perceived obtaining funding and getting a job in the field of consciousness research as more difficult than in other subfields of neuroscience. Overall, work done in consciousness research was perceived to be less rigorous than other neuroscience subfields, but this perceived lack of rigor was not related to the perceived difficulty in finding jobs and obtaining funding. Lastly, we found that, overall, the global workspace theory was perceived to be the most promising (around 28%), while most non-expert researchers (around 22% of non-experts) found the integrated information theory (IIT) most promising. We believe the survey results provide an interesting picture of current opinions from scientists and researchers about the progresses made and the challenges faced by consciousness research as an independent field. They will inspire collective reflection on the future directions regarding funding and job opportunities for the field. (shrink)

L’enfant exposé aux violences conjugales est encore trop peu considéré comme victime directe de ces violences, malgré les études réalisées en France et en Amérique du Nord. Les auteures ont mené une recherche qualitative clinique auprès de huit enfants témoins de violences conjugales durant leur petite enfance, accueillis avec leur mère dans deux structures dédiées, afin d’étudier leur fonctionnement psychique en leur proposant le test projectif du Patte-Noire. L’intérêt de cette étude réside dans le fait de recueillir la parole de (...) l’enfant, alors que les recherches internationales sont souvent basées sur des questionnaires adressés à la mère. Les résultats révèlent l’intériorisation précoce de modalités relationnelles violentes et pointent l’importance d’un accompagnement sur le versant psychologique de l’enfant et du (des) parent(s). (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

Henri Lefebvre a développé une œuvre riche sur l'urbain et la ville. Dans les années 1980, il travaille à une rythmanalyse qui, par bien des aspects, complète cette réflexion. La rythmanalyse peut être définie comme une science devenue pratique, qui consiste en la saisie des modalités des temps et des espaces sociaux concrets par les rythmes. Cette saisie s'effectue par le corps dans sa sensibilité et vise à sa thérapie, à son rétablissement face à son mépris dans la modernité et (...) l'urbain. Le corps est le - Urbanisme – Nouvel article. (shrink)

Partant du constat que l’amitié n’est pas traitée par les femmes écrivains, cet article relit et analyse la portée du célèbre roman Kokoro de l’écrivain Natsume Sôseki (1867-1916), pilier de la littérature japonaise moderne, qui repose sur deux histoires consécutives d’amitié. Un jeune homme découvre l’amitié avec un homme un peu plus âgé, qui a lui-même dans sa jeunesse connu une amitié très vive avec un jeune homme du même village, avant qu’une histoire d’amour les séparent tragiquement. La lecture de (...) ce récit fondateur, pendant longtemps commune à tous les lycéens nippons, a assurément contribué au façonnement de la notion d’amitié au Japon. Il s’agit dans le roman d’un lien exigeant qui ne peut souffrir aucune trahison. (shrink)

Partant du constat que l’amitié n’est pas traitée par les femmes écrivains, cet article relit et analyse la portée du célèbre roman Kokoro de l’écrivain Natsume Sôseki (1867-1916), pilier de la littérature japonaise moderne, qui repose sur deux histoires consécutives d’amitié. Un jeune homme découvre l’amitié avec un homme un peu plus âgé, qui a lui-même dans sa jeunesse connu une amitié très vive avec un jeune homme du même village, avant qu’une histoire d’amour les séparent tragiquement. La lecture de (...) ce récit fondateur, pendant longtemps commune à tous les lycéens nippons, a assurément contribué au façonnement de la notion d’amitié au Japon. Il s’agit dans le roman d’un lien exigeant qui ne peut souffrir aucune trahison. (shrink)

Sommes-nous tous malades? La médecine, ses approches de l'humain, son vocabulaire ont pénétré dans notre univers quotidien. Une telle médicalisation de notre existence n'est pas sans effet. Les problèmes du corps et de l'âme se voient systématiquement redéfinis en pathologies et les différentes phases de la vie accompagnées de l'aide technique médicale. Celle-ci esquisse la figure d'un homme amélioré par les biotechnologies, débarrassé des aléas des passions, maîtrisant ses colères et ses pulsions: un homme sans fièvre. Ainsi paradoxalement, à mesure (...) que la médecine identifie toujours plus de maladies, les hommes rèvent de parfaite guérison et en font à la fois une exigence personnelle et un idéal social. Guérir la société de ses blessures, nous défaire de notre vulnérabilité; telle est la manière dont est interprétée trop rapidement l'idée d'une société du soin proposée par de nouvelles philosophies. Pourtant, soigner n'est pas un geste anodin, guérir ne se fait pas sans souffrance et généraliser le modèle médical, c'est aussi prendre le risque de banaliser sa violence spécifique. (shrink)

Rare copy number variants have a prominent role in the aetiology of schizophrenia and other neuropsychiatric disorders. Substantial risk for schizophrenia is conferred by large CNVs at several loci, including microdeletions at 1q21.1, 3q29, 15q13.3 and 22q11.2 and microduplication at 16p11.2. However, these CNVs collectively account for a small fraction of cases, and the relevant genes and neurobiological mechanisms are not well understood. Here we performed a large two-stage genome-wide scan of rare CNVs and report the significant association of copy (...) number gains at chromosome 7q36.3 with schizophrenia. Microduplications with variable breakpoints occurred within a 362-kilobase region and were detected in 29 of 8,290 patients versus 2 of 7,431 controls in the combined sample. All duplications overlapped or were located within 89 kilobases upstream of the vasoactive intestinal peptide receptor gene VIPR2. VIPR2 transcription and cyclic-AMP signalling were significantly increased in cultured lymphocytes from patients with microduplications of 7q36.3. These findings implicate altered vasoactive intestinal peptide signalling in the pathogenesis of schizophrenia and indicate the VPAC2 receptor as a potential target for the development of new antipsychotic drugs. © 2011 Macmillan Publishers Limited. All rights reserved. (shrink)

L’analyse d’itinéraires féminins à travers l’histoire du Comité Catholique des Intellectuels Français (CCIF) met en valeur trois profils d’intellectuelles catholiques qui cherchent à résoudre les interrogations posées à l’intelligence croyante par les derniers développements de la connaissance. La majeure partie de ces femmes forment ainsi un groupe d’expertes qui refusent de s’engager au service d’une cause politique ou sociale. Elles sont donc bien éloignées du modèle intellectuel qui prévaut alors et qu’incarne Jean-Paul Sartre.

This paper aims at exploring the field of relations between Merleau-Ponty and Marx. Re-reading the unpublished texts from the 1940s and 1950s, the intention is to demonstrate that Merleau-Ponty uses The Economic and Philosophic Manuscript of 1844 not only in a political way, but also in a philosophical way. In an original interpretive approach concerning the question of Nature, the paper seeks to demonstrate that this conception suggests that Marx takes on a new place in the development leading from a (...) phenomenology of perception to an ontology of Nature, particularly in the lectures at the College de France in 1956. At the end of this paper, the emphasis is placed on Merleau-Ponty’s attempt to build a new philosophy of action and History, based upon this analysis of Nature. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

Ce texte a avant tout une valeur exploratoire. J'ai essayé de rassembler les différents thèmes que pourrait couvrir une réflexion sur le rythme et l'urbanisme ou aménagement de l'espace urbain au sens large, qui ne se limite pas à la « ville » mais à l'espace-temps produit par notre société urbaine, afin de proposer une approche complémentaire. Le rythme, une question nouvelle pour l'urbanisme et l'aménagement Qu'entend-on, avant toute chose, par urbanisme et aménagement, et en quoi ces disciplines ou - (...) Urbanisme – Nouvel article. (shrink)