RationaleSurrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers.ObjectiveTo determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness.MethodsThis was a multicenter study at three academic medical centers in California, Pennsylvania, and Washington. One hundred eighteen key stakeholders completed in-depth semistructured (...) interviews. Participants included 47 surrogates of adult patients with acute respiratory distress syndrome; 45 clinicians working in study ICUs, including physicians, nurses, social workers, and spiritual care providers; and 26 experts in health communication, decision science, ethics, family-centered care, geriatrics, healthcare disparities, palliative care, psychology, psychiatry, and critical care.Measurements and main resultsThere was broad support among surrogates for existing expert recommendations, including truthful prognostic disclosure, emotional support, tailoring the disclosure strategy to each family's needs, and checking for understanding. In addition, stakeholders offered suggestions that add specificity to existing recommendations, including: In addition to conveying prognostic estimates, clinicians should help families "see the prognosis for themselves" by showing families radiographic images and explaining the clinical significance of physical manifestations of severe disease at the bedside. Many physicians did not support using numeric estimates to convey prognosis to families, whereas many surrogates, clinicians from other disciplines, and experts believed numbers could be helpful. Clinicians should conceptualize prognostic communication as an iterative process that begins with a preliminary mention of the possibility of death early in the ICU stay and becomes more detailed as the clinical situation develops. Although prognostic information should be initially disclosed by physicians, other members of the multidisciplinary team-nurses, social workers, and spiritual care providers-should be given explicit role responsibilities to reinforce physicians' prognostications and help families process a poor prognosis emotionally.ConclusionsFamily members, clinicians, and experts identified specific communication behaviors that clinicians should use to discuss prognosis in the critical care setting. These findings extend existing opinion-based recommendations and should guide interventions to improve communication about prognosis in ICUs. (shrink)

As understanding of the human microbiome improves, novel therapeutic targets to improve human health with microbial therapeutics will continue to expand. We outline key considerations of balancing risks and benefits, optimising access, returning key results to research participants, and potential conflicts of interest.

Graphic and gut-wrenching images of death, violence, and pain fill our news media, despite debate about their effect on audiences and their potential to harm their subjects. This research uses in-d...

Information can be public among a group. Whether or not information is public matters, for example, for accounts of interdependent rational choice, of communication, and of joint intention. A standard analysis of public information identifies it with (some variant of) common belief. The latter notion is stipulatively defined as an infinite conjunction: for p to be commonly believed is for it to believed by all members of a group, for all members to believe that all members believe it, and so (...) forth. This analysis is often presupposed without much argument in philosophy. Theoretical entrenchment or intuitions about cases might give some traction on the question, but give little insight about why the identification holds, if it does. The strategy of this paper is to characterize a practical-normative role for information being public, and show that the only things that play that role are (variants of) common belief as stipulatively characterized. In more detail: a functional role for “taking a proposition for granted” in non-isolated decision making is characterized. I then present some minimal conditions under which such an attitude is correctly held. The key assumption links this attitude to beliefs about what is public. From minimal a priori principles, we can argue that a proposition being public among a group entails common commitment to believe among that group. Later sections explore partial converses to this result, the factivity of publicity and publicity from the perspective of outsiders to the group, and objections to the aprioricity of the result deriving from a posteriori existential presuppositions. (shrink)

This article analyzes the photographic exhibit Yuyanapaq: Para Recordar, which was a product of the Peruvian Truth and Reconciliation Commission. It focuses specifically on the curatorial process and political desires shaping Yuyanapaq, and it examines the ways in which photographs were intended to intervene in and script a national consciousness and shared memory during and after Peru’s transition process. Exploring across the three iterations of Yuyanapaq, I ask how we might attempt to bear witness to past conflict without inadvertently perpetuating (...) its logic. (shrink)

Seminary students remain unstudied in the research literature despite their eminent role in caring for the wellbeing of congregants. This study aimed to conduct baseline analysis of their family of origin health, psychological health, and physiological heath by utilizing the Biobehavioral Family Model as a conceptual framework for understanding the associations between these constructs. Statistical analysis utilizing structural equation modeling provided support that the BBFM was a sound model for assessing the relationships between these constructs within a seminary sample. Additionally, (...) seminarians were found to have higher rates of anxiety and depression when compared to the general population. Together, findings indicate that clinical care for seminarians may be best if implemented from a global systemic perspective. (shrink)

When someone encounters an explanation perceived as weak, this may lead to a feeling of deprivation or tension that can be resolved by engaging in additional learning. This study examined to what extent children respond to weak explanations by seeking additional learning opportunities. Seven‐ to ten‐year‐olds (N = 81) explored questions and explanations (circular or mechanistic) about 12 animals using a novel Android tablet application. After rating the quality of an initial explanation, children could request and receive additional information or (...) return to the main menu to choose a new animal to explore. Consistent with past research, there were both developmental and IQ‐related differences in how children evaluated explanation quality. But across development, children were more likely to request additional information in response to circular explanations than mechanistic explanations. Importantly, children were also more likely to request additional information in direct response to explanations that they themselves had assigned low ratings, regardless of explanation type. In addition, there was significant variability in both children's explanation evaluation and their exploration, suggesting important directions for future research. The findings support the deprivation theory of curiosity and offer implications for education. (shrink)

Researchers investigating gender and anger have consistently found that White women, but not White men, are evaluated unfavorably when experiencing anger in the workplace. Our project originally aimed to extend findings on White women’s, Black women’s, and White men’s workplace anger by examining whether evaluations are exacerbated or buffered by invalidating or affirming comments from others. In stark contrast to previous research on gender stereotyping and anger evaluations, however, results across four studies (N= 1,095) showed that both Black and White (...) women portrayed as experiencing anger in the workplace were evaluatedmore favorablythan White men doing so. After Study 1’s initial failure to conceptually replicate, we investigated whether perceivers’ evaluations of women’s workplace anger could have been affected by the contemporaneous cultural event of #MeToo. Supporting this possibility, we found evaluations were moderated by news engagement and beliefs that workplace opportunities are gendered. Additionally, we found invalidating comments rarely affected evaluations of a protagonist yet affirming comments tended to favorably affect evaluations. Overall, findings suggest the need for psychologists to consider the temporary, or perhaps lasting, effects of cultural events on research outcomes. (shrink)

Telling a patient that the outcome of his illness is not good, or even hopeless, requires sensitivity and the ability to communicate with him in the setting of a hospital which is an unnatural environment divorced from family and friends. It is a task which must be taught and learned by doctors and nurses.

The achievements of the textile industry in Roman Britain are often underestimated as a result of the meagreness of our available evidence. The Edict on maximum prices issued by Diocletian in A.D. 301 shows that British capes commanded high prices on the markets of the Empire, and that in the late third century A.D. British rugs were the best in the world. In view of the competition from the traditional centres of rug manufacture in the East, this is an astonishing (...) achievement. (shrink)

The received translation and interpretation of many of the technical terms current in the textile industry of the Roman Empire are inaccurate, because lexicographers have either fought shy of being precise, or have thought that they recognized in the ancient world technical processes which originated at a much later date. The evidence is often equivocal or insufficient, but may still yield details that have been overlooked. The textile expression scutulatus, to take an example, deserves more attention than Blümner has devoted (...) to it. When it refers to the appearance of a garment, Lewis and Short, s.v. scutulatus, translate ‘diamond or lozenge-shaped, checkered’. It seems worth while to attempt a more precise translation, and, if possible, to estimate the significance in context of the goods so designated. (shrink)

Living out of silence, out of a fully functioning, lovingly attentive mind, and not just out of thought, out of a partially functioning mind, is requisite for depth or profundity in living or relating. A fully attentive, truly silent or meditative mind sees that there is real dualism of time and the timeless and that time and the timeless each has its own unique value. The timeless, or real silence, that which alone can make for depth in one's living and (...) relating, can be there only when, in one's awareness, time and all that is related to time, have come to an end. An examination of a wide variety of statements made by writers, both past and present, shows that these understandings are seldom there in contemporary writings, just as they were not there in writings that have come down to us from the past. 'Living beyond the One and the Many' invites readers to consider the possibility that what is presented in it can bring deep meaning to one's way of living in the world"--Publisher's description, back cover. (shrink)

If the world itself is metaphysically indeterminate in a specified respect, what follows? In this paper, we develop a theory of metaphysical indeterminacy answering this question.

Husserlian phenomenology, as the study of conscious experience, has often been accused of solipsism. Husserl’s method, it is argued, does not have the resources to provide an account of consciousness of other minds. This chapter will address this issue by providing a brief overview of the multiple angles from which Husserl approached the theme of intersubjectivity, with specific focus on the details of his account of the concrete interpersonal encounter – “empathy.” Husserl understood empathy as a direct, quasi-perceptual form of (...) intentionality through which the sense of the Other is constituted. Furthermore, his account of empathy is holistically integrated with his overall theory of intersubjectivity, including his discussions of the objectivity of nature, and the social, historical, and communal aspects of subjectivity. Husserl’s theory of empathy continues to cast a long shadow, influencing both the analytic and continental approaches to the problem of other minds, as well as contemporary account of social cognition in the cognitive sciences. (shrink)

An Essay on Human Action seeks to provide a comprehensive, detailed, enlightening, and (in its detail) original account of human action. This account presupposes a theory of events as abstract, proposition-like entities, a theory which is given in the first chapter of the book. The core-issues of action-theory are then treated: what acting in general is (a version of the traditional volitional theory is proposed and defended); how actions are to be individuated; how long actions last; what acting intentionally is; (...) what doing one thing by doing another is; what basic action is; and what omitting to do something is. Attention is also given to the concepts of causation, intention, volition, deciding, choosing, and trying. Finally, a libertarian account of free action is tentatively proposed and defended. (shrink)

We develop and apply a multi-dimensional conception of explanatory depth towards a comparative analysis of inflationary and bouncing paradigms in primordial cosmology. Our analysis builds on earlier work due to Azhar and Loeb (2021) that establishes initial condition fine-tuning as a dimension of explanatory depth relevant to debates in contemporary cosmology. We propose dynamical fine-tuning and autonomy as two further dimensions of depth in the context of problems with instability and trans-Planckian modes that afflict bouncing and inflationary approaches respectively. In (...) the context of the latter issue, we argue that the recently formulated trans-Planckian censorship conjecture leads to a trade-off for inflationary models between dynamical fine-tuning and autonomy. We conclude with the suggestion that explanatory preference with regard to the different dimensions of depth is best understood in terms of differing attitudes towards heuristics for future model building. (shrink)

Global Media Ethics is the first comprehensive cross-cultural exploration of the conceptual and practical issues facing media ethics in a global world. A team of leading journalism experts investigate the impact of major global trends on responsible journalism. The first full-length, truly global textbook on media ethics; Explores how current global changes in media promote and inhibit responsible journalism; Includes relevant and timely ethical discussions based on major trends in journalism and global media; Questions existing frameworks in media ethics in (...) light of the impact of global media; Contributors are leading experts in global journalism and communication. (shrink)

The existential analysis -- The death of dasein -- The timeliness of dasein -- The derivation of time -- The time of being.

We live in turbulent times, our world is changing at accelerating speed. Information is everywhere, but wisdom appears in short supply when trying to address key inter-related challenges of our time such as; runaway climate change, the loss of biodiversity, the depletion of natural resources, the on-going homogenization of culture, and rising inequity. Living in such times has implications for education and learning. This book explores the possibilities of designing and facilitating learning-based change and transitions towards sustainability. In 31 chapters (...) contributors from across the world discuss (re)emerging forms of learning that not only assist in breaking down unsustainable routines, forms of governance, production and consumption, but also can help create ones that are more sustainable. The book has been divided into three parts: re-orienting science and society, re-connecting people and planet and re-imagining education and learning. This is essential reading for educators, educational designers, change agents, researchers, students, policymakers and entrepreneurs alike, who are concerned about the well-being of the planet and convinced of our ability to do better. The content and related issues can be discussed on the blog by editor Arjen Wals: Transformative learning. 'We are living in times of incertitude, complexity, and contestation, but also of connectivity, responsibility, and new opportunities. This book analyses the consequences of these times for learning in formal, non-formal, and informal education. It explores the possibilities offered by the concept of sustainability as a central category of a holistic paradigm which harmonizes human beings with Earth. To change people and to change the world are interdependent processes - this book contributes to both.' Moacir Gadotti, Director of Paulo Freire Institute, São Paulo, Brazil 'I hope you share my excitement about the innovations for sustainability that this book catalogues and analyses. While the ecological news is grim, the human news is not. Even in a time of accelerating change, people are showing their enormous capacities to learn, adapt, restore and protect.' From the Foreword by Juliet Schor, author of ‘True Wealth: how and why millions of Americans are creating a time-rich, ecologically-light, small-scale high-satisfaction economy’ 'This book implies a ‘culture of critical commitment’ in educational thinking and practice - engaged enough to make a real difference to social-ecological resilience and sustainability but reflexively critical enough to learn constantly from experience and to keep options open in working for a sustainability transformation.' From the Afterword by Stephen Sterling, Professor of Sustainability Education, Centre for Sustainable Futures, Plymouth University, United Kingdom. (shrink)

What Is Political Theory? provides students with a comprehensive overview of the current state of the discipline. Ten substantive chapters address the most pressing topics in political theory today, including: - what resources do the classic texts still provide for political theorists? - what areas will political theorists focus on in the future? - can western political theory alone continue to provide a framework for responding to the challenges of modern political life? The authors assess the intellectual challenges to conventional (...) political theory, such as post-structuralism and the scientific study of politics that have revitalized the field in the last 30 years. They also broaden the perspective to take in non-western ideas and to reconceptualize political theory in the light of specifically global challenges. Students and teachers of political theory and political philosophy will find this book invaluable in understanding the factors that have shaped current political theory and which will guide its future development. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Cognitive Error and Contemplative Practices:The Cultivation of Discernment in Mind and HeartWesley J. WildmanBrains are amazing organs in all creatures with central nervous systems and especially in human beings. But they are not perfect. Without forgetting the larger success story of cognitive evolution, I want to explore the way that cognitive biases sometimes produce errors in both religious and secular social settings and how such errors can be diagnosed (...) and corrected when they occur. This will involve noticing that error diagnosis and correction is a process that certain social groups have a vested interest in resisting or neglecting, in some respects, while the very same social groups may furnish resources that support the detection of cognitive errors, in other respects.This presents a moral quandary for both secular and religious groups. Should we educate children to be fully aware of their cognitive vulnerability to advertising, thereby learning how to resist and eventually become immune to one of the fundamental power sources of modern market economies? Should religious groups explain to young people their cognitive tendencies to posit the action of supernatural beings whether or not any such action exists, even though this may disrupt the power of religious groups to forge bracing social togetherness that supports psychologically useful coping skills? While I do not seek to answer such complex moral questions in this paper, I do argue that knowledge of cognitive biases and the resulting tendencies to cognitive error, self-defeating behaviors, and self-deception should be made available to those individuals and groups who are interested in promoting a high degree of critical self-awareness in the analysis of beliefs and behaviors in both secular and religious contexts.The term "error" is a potentially problematic one in that it misleadingly suggests that there might be a uniquely correct way in which cognition should work. I do not wish to suggest such a binary opposition. After all, biases exist in the human cognitive system either because they have been selected in the evolutionary process for their survival benefits or because they are side effects of other traits selected for their usefulness. My concern is with the wondrous human discovery that we can analyze [End Page 61] our behaviors and beliefs with such precision that we can sometimes detect when our cognitive biases produce mistaken beliefs and self-defeating behaviors. This forms the basis for my contention that cognition can often work better than it does—more accurately, less self-destructively—when tendencies to cognitive error are diagnosed, corrected, and perhaps even systematically resisted.The profound irony here is that the very same social groups (secular and religious) with an obvious vested interest in resisting such enlightenment in some respects can also promote processes of discernment and insight in other respects. Existing literature in the cognitive psychology of religion rarely bothers with such subtleties. It is common to assume that simply to notice the operation of cognitive biases in religion—say, in supporting belief in supernatural entities who providentially interact in human affairs, or in establishing and reinforcing people's willingness to defer to certain kinds of religious authority—is at the same time to establish the presence of rampant cognitive error, massive resistance to diagnosing and correcting it, and thus the infliction of pernicious cruelties on young children who have no way of escaping the resulting irrational indoctrination.This moral reflex to condemn religious groups because of their characteristic reluctance to acknowledge the role of cognitive biases in their beliefs and practices is understandable given the irrationality, ignorance, or denial that such reluctance suggests. I frankly acknowledge that I share this moral concern. But the actual complexities of religious practice demonstrate that the situation demands a subtler evaluation. Resistance to awareness of cognitive biases exists both inside and outside religious groups; economic and political practices in all eras and of all types have every bit as much to gain from neglecting to enlighten people about their cognitive operations as religious groups do—just consider the techniques employed in commercial advertising and political campaigns. Moreover, religious groups also promote methods of discernment and self-awareness that have historically been, and continue to be, the dominant method by which... (shrink)

The legal environment -- Regulation of nursing practice -- Nurses in legal actions -- Standards of care -- Defenses to negligence or malpractice -- Prevention of malpractice -- Nurses as witnesses -- Professional liability insurance -- Accepting or refusing an assignment/patient abandonment -- Delegation to unlicensed assistive personnel -- Patients' rights and responsibilities -- Confidential communication -- Competency and guardianship -- Informed consent -- Refusal of treatment -- Pain control -- Patient teaching and health counseling -- Medication administration -- Clients (...) with AIDS and HIV testing -- Abusive situations -- Reproductive services -- Restraints -- Emergency psychiatric admissions -- Organ and tissue donation and transplantation -- Discharge against medical advice -- The medical record and documentation standards -- Electronic health information and communications -- Interdependent nursing functions: verbal orders and telenursing -- Event reporting and compliance -- Quality and safety in nursing practice -- Forensic issues -- Employer and employee rights -- Contracts -- Corporate liability -- Employment contracts and unionization -- Employment status liability -- Staffing issues and floating -- Americans with Disabilities Act -- Employees with AIDS/HIV infection and exposure to bloodborne pathogens -- Impaired nurses -- Sexual harassment in the workplace -- Violence in the workplace -- Intentional torts -- Environmental health and safety -- Ethical decision making -- Professional boundaries and patient relationships -- Moral courage and patient advocacy -- Social media and online professionalism -- Reporting illegal, unethical, or unsafe conduct -- Maternal versus fetal rights -- Futility of care -- Advance directives and end-of-life decisions -- Assisted suicide. (shrink)