Difficulty engaging in reciprocal social interactions is a core characteristic of autism spectrum disorder. The mechanisms supporting effective dynamic real-time social exchanges are not yet well understood. This proof-of-concept hyperscanning electroencephalography study examined neural synchrony as the mechanism supporting interpersonal social interaction in 34 adolescents with autism spectrum disorder, age 10–16 years, paired with neurotypical confederates of similar age. The degree of brain-to-brain neural synchrony was quantified at temporo-parietal scalp locations as the circular correlation of oscillatory amplitudes in theta, alpha, (...) and beta frequency bands while the participants engaged in a friendly conversation. In line with the hypotheses, interpersonal neural synchrony was significantly greater during the social interaction compared to the baseline. Lower levels of synchrony were associated with increased behavioral symptoms of social difficulties. With regard to sex differences, we found evidence for stronger interpersonal neural synchrony during conversation than baseline in females with autism, but not in male participants, for whom such condition differences did not reach statistical significance. This study established the feasibility of hyperscanning during real-time social interactions as an informative approach to examine social competence in autism, demonstrated that neural coordination of activity between the interacting brains may contribute to social behavior, and offered new insights into sex-related variability in social functioning in individuals with autism spectrum disorders. (shrink)

Due to their consolidated nature, corporate sustainability reports often mask the evolution of organizations’ sustainability initiatives. Thus, to more fully understand the environmental performance of an organization, it is essential to examine the experiences of specific projects and how they relate to corporate sustainability. Based on case studies of green projects in four different organizations, we find that it is difficult to determine the environmental impact of a project a priori, even in cases where environmental considerations are included as part (...) of the initial project scope. Instead, the decision to integrate environmentally favorable elements into projects is a dynamically occurring interaction between competing institutional logics and organizational identities, which create windows of opportunity for individual agency. During these windows, individuals may engage in reinforcing microprocesses that support traditional practices, or invoke enabling microprocesses to facilitate green decision-making, consistent with ecosystem logics. The process model developed in this paper provides a new perspective on the temporal and contextual dimensions of environmental championship behaviors, and sheds light on otherwise puzzling results such as why organizations with strong environmental orientations continue to struggle with delivering projects with strong positive environmental impacts. (shrink)

Market metaphors have come to dominate discourse on medical practice. In this essay, we revisit Peter Berger and colleagues’ analysis of modernization in their book The Homeless Mind and place that analysis in conversation with Max Weber’s 1917 lecture “Science as a Vocation” to argue that the rise of market metaphors betokens the carry-over to medical practice of various features from the institutions of technological production and bureaucratic administration. We refer to this carry-over as the product presumption. The product presumption (...) foregrounds accidental features of medicine while hiding its essential features. It thereby confounds the public understanding of medicine and impedes the professional achievement of the excellences most central to medical practice. In demonstrating this pattern, we focus on a recent article, “Physicians, Not Conscripts—Conscientious Objection in Health Care,” in which Ronit Stahl and Ezekiel Emanuel decry conscientious refusals by medical practitioners. We demonstrate that Stahl and Emanuel’s argument depends on the product presumption, ignoring and undermining central features of good medicine. We conclude by encouraging conscientious resistance to the product presumption and the language it engenders. (shrink)

Three ethical conflicts in particular are paradigmatic of what we define as “clerkship ethics.” First, a distinction that differentiates the clerkship student from the practicing physician involves the student’s principal role as a learner. The clerkship student must skillfully balance her commitment to her own education against her commitment to patient care in a fashion that may compromise patient care. While the practicing physician can often resolve the tension between these two goods when they come into conflict, the clerkship student (...) is left with a more ambiguous set of choices. Second, evaluative scrutiny during clinical clerkships often forces medical students to balance doing what is morally fitting against the perceived expectations of the medical teams in which they work. Third and finally, a deeply entrenched culture of medical hierarchy presents a particular challenge to innovation and improvement in ethics education during the clerkship years. Students regard faculty as exemplars, but are not provided with the tools to assess when technical medical competence is not matched by moral competence; moreover, these faculty are unlikely to have experienced the ethics education in which students are asked to demonstrate mastery. (shrink)

The geometry of the state space of a finite-dimensional quantum mechanical system, with particular reference to four dimensions, is studied. Many novel features, not evident in the two-dimensional space of a single spin, are found. Although the state space is a convex set, it is not a ball, and its boundary contains mixed states in addition to the pure states, which form a low-dimensional submanifold. The appropriate language to describe the role of the observer is that of flag manifolds.

In their target article, Millum and Bromwich situate their article against a backdrop of well-documented empirical research demonstrating that many participants have variable and often poor...

Colexification refers to the phenomenon of multiple meanings sharing one word in a language. Cross‐linguistic lexification patterns have been shown to be largely predictable, as similar concepts are often colexified. We test a recent claim that, beyond this general tendency, communicative needs play an important role in shaping colexification patterns. We approach this question by means of a series of human experiments, using an artificial language communication game paradigm. Our results across four experiments match the previous cross‐linguistic findings: all other (...) things being equal, speakers do prefer to colexify similar concepts. However, we also find evidence supporting the communicative need hypothesis: when faced with a frequent need to distinguish similar pairs of meanings, speakadjust their colexification preferences to maintain communicative efficiency and avoid colexifying those similar meanings which need to be distinguished in communication. This research provides further evidence to support the argument that languages are shaped by the needs and preferences of their speakers. (shrink)

A large proportion of the total global burden of disease is caused by emergency medical conditions. Emergency care research is essential to improving emergency medicine but this research can raise some distinctive ethical challenges, especially with regard to (1) standard of care and risk–benefit assessment; (2) blurring of the roles of clinician and researcher; (3) enrolment of populations with intersecting vulnerabilities; (4) fair participant selection; (5) quality of consent; and (6) community engagement. Despite the importance of research to improve emergency (...) care in low-income and middle-income countries (LMICs) and the widely acknowledged ethical challenges, very little has been written on the ethics of emergency care research in LMICs. This paper examines the ethical and regulatory challenges to conducting emergency care research with human participants in LMICs. We outline key challenges, present potential solutions or frameworks for addressing these challenges, and identify gaps. Despite the ethical and regulatory challenges, conducting high-quality, ethical emergency care research in LMICs is possible and it is essential for global health. (shrink)

As we begin our exploration of our relationship with animals, we come face to face with Peter Singer and his insistence that speciesism is a vice. It is important to come to know what he means by speciesism, why he regards it as a moral mistake.

We identify the \-ideals of a distributive demi-pseudocomplemented algebra L as the kernels of the boolean congruences on L, and show that they form a complete Heyting algebra which is isomorphic to the interval \ of the congruence lattice of L where G is the Glivenko congruence. We also show that the notions of maximal \-ideal, prime \-ideal, and falsity ideal coincide.

Cross-situational learning is a mechanism for learning the meaning of words across multiple exposures, despite exposure-by-exposure uncertainty as to the word's true meaning. We present experimental evidence showing that humans learn words effectively using cross-situational learning, even at high levels of referential uncertainty. Both overall success rates and the time taken to learn words are affected by the degree of referential uncertainty, with greater referential uncertainty leading to less reliable, slower learning. Words are also learned less successfully and more slowly (...) if they are presented interleaved with occurrences of other words, although this effect is relatively weak. We present additional analyses of participants’ trial-by-trial behavior showing that participants make use of various cross-situational learning strategies, depending on the difficulty of the word-learning task. When referential uncertainty is low, participants generally apply a rigorous eliminative approach to cross-situational learning. When referential uncertainty is high, or exposures to different words are interleaved, participants apply a frequentist approximation to this eliminative approach. We further suggest that these two ways of exploiting cross-situational information reside on a continuum of learning strategies, underpinned by a single simple associative learning mechanism. (shrink)

Bonnie Steinbock argues that Peter Singer has made an important contribution to remind us that animals deserve very special consideration, but that he fails to make a compelling case against "speciesism.".

Selected as a Financial Times Best Book of 2013Governments today in both Europe and the United States have succeeded in casting government spending as reckless wastefulness that has made the economy worse. In contrast, they have advanced a policy of draconian budget cuts--austerity--to solve the financial crisis. We are told that we have all lived beyond our means and now need to tighten our belts. This view conveniently forgets where all that debt came from. Not from an orgy of government (...) spending, but as the direct result of bailing out, recapitalizing, and adding liquidity to the broken banking system. Through these actions private debt was rechristened as government debt while those responsible for generating it walked away scot free, placing the blame on the state, and the burden on the taxpayer. That burden now takes the form of a global turn to austerity, the policy of reducing domestic wages and prices to restore competitiveness and balance the budget. The problem, according to political economist Mark Blyth, is that austerity is a very dangerous idea. First of all, it doesn't work. As the past four years and countless historical examples from the last 100 years show, while it makes sense for any one state to try and cut its way to growth, it simply cannot work when all states try it simultaneously: all we do is shrink the economy. In the worst case, austerity policies worsened the Great Depression and created the conditions for seizures of power by the forces responsible for the Second World War: the Nazis and the Japanese military establishment. As Blyth amply demonstrates, the arguments for austerity are tenuous and the evidence thin. Rather than expanding growth and opportunity, the repeated revival of this dead economic idea has almost always led to low growth along with increases in wealth and income inequality. Austerity demolishes the conventional wisdom, marshaling an army of facts to demand that we austerity for what it is, and what it costs us. (shrink)

Some patients who are dependent on extracorporeal membrane oxygenation (ECMO) are alert and retain capacity to participate in decision-making, including decisions regarding whether to continue life...

Recovering Reason: Essays in Honor of Thomas L. Pangle is a collection of essays composed by students and friends of Thomas L. Pangle to honor his seminal work and outstanding guidance in the study of political philosophy. These essays examine both Socrates' and modern political philosophers' attempts to answer the question of the right life for human beings, as those attempts are introduced and elaborated in the work of thinkers from Homer and Thucydides to Nietzsche and Charles Taylor.

This essay is a short response to comments made by Cannon, Meeks, and Yu to my articles “Beyond Subjectivism,” published in this special edition of Tradition and Discovery (34:1), and “Connected andSeparate Knowing: A Marriage of Two Minds,” published in Knowledge, Difference, and Power, edited by Nancy Goldberger, et al., focusing on convergences between my work and the ideas of Michael Polanyi.

Literature on racism, anti‐racism, whiteness, nursing education and nurse educators was reviewed and analysed for the development of race consciousness and application of anti‐racist pedagogy. The literature describes an oppressive educational climate for non‐white identifying people, a curriculum that does not attend to the social construction of difference, and a nursing culture that is not consciously situated in a broader sociopolitical context. A particular focus on studies of nurse educators demonstrates a stark need for personal and professional development towards effectively (...) delivering anti‐racist pedagogy and a deconstruction of white normativity and dominance amongst white faculty. The protection and reproduction of white privilege is identified through the scholarship itself through a lack of racial analysis, an externalization of the root of oppression and non‐specific study measures and outcomes. The persistence and pervasiveness of white dominance in nursing and the lack of anti‐racist competence in white educators, particularly, merits a shift in anti‐racist efforts away from short‐term skill acquisition initiatives towards the deconstruction of socialized white supremacy and enactments of white privilege in nurse educators themselves. (shrink)

In this essay on epistemological development in college students, I argue that “subjectivism” (a.k.a. “multiplism;” often identified in female undergraduates) should be understood and treated not as amanifestation of a primitive, irrational notion of knowing that must be exterminated and replaced by the more impersonal, detached, objective procedures embodied in scientific method and critical thinking. Rather, it should be regarded as a point of departure for moving into more reflective modes of thought when approached via, and encouraged into, the more (...) personal, empathic procedure made known in Women’s Ways of Knowing as “connected knowing.” Along the way, I develop further the difference between “connected knowing” and “separate knowing” (the latter being the dominant academic paradigm of knowing), bringing out how connected knowing is an important and at times indispensable complement to separate knowing in achieving an objectivity integrated with subjectivity. (shrink)

In the present essay, I explore some ways in which Polanyi’s concepts can be applied to enrich our understanding of epistemological development and the educational practices that seem to facilitate orsuppress it. Among the concepts discussed are Polanyi’s notion of uncertainty, combined with confidence as driving intellectual activity; the role of conviviality in the collaborative construction of knowledge,· the act of discovery as beginning with a problem that obsesses the thinker and proceeding through the integration of (often tacit) fragments into (...) a coherent whole; the notion of personal knowledge and commitment as transcending the disjunction between subjective and objective; apprenticeship as a personal relationship between a learner and a more sophisticated master, and most important, the assertion that beliefis prior to doubt. Thus, in terms ofthe concepts my colleagues and I have developed, “connected knowing” (a personal approach) is not simply equal to “separate knowing” (a detached, impersonal mode) as a procedure for arriving at knowledge, but is prior to it, “making meaning” being a necessary prerequisite to testing the validity ofa position. Drawing on interview data and memoirs of academic experiences, I argue that because these priorities are often reversed in educational practice, students learn to delete their personal responses from their essays in order to meet what they perceive as the utterly objective standards of the academy. When educators “endorse” uncertainty, students are encouraged to engage in the collaborative making of meaning and the pursuit of problems of personal importance. (shrink)

As face shields are dusted off and conferences go virtual again, Omicron reminds us how the once-novel coronavirus ruptured our collective idea of medical training. For nearly 2 years, social media...

Despite the accumulation of substantial cognitive science research relevant to education, there remains confusion and controversy in the application of research to educational practice. In support of a more systematic approach, we describe the Knowledge-Learning-Instruction (KLI) framework. KLI promotes the emergence of instructional principles of high potential for generality, while explicitly identifying constraints of and opportunities for detailed analysis of the knowledge students may acquire in courses. Drawing on research across domains of science, math, and language learning, we illustrate the (...) analyses of knowledge, learning, and instructional events that the KLI framework affords. We present a set of three coordinated taxonomies of knowledge, learning, and instruction. For example, we identify three broad classes of learning events (LEs): (a) memory and fluency processes, (b) induction and refinement processes, and (c) understanding and sense-making processes, and we show how these can lead to different knowledge changes and constraints on optimal instructional choices. (shrink)

The goal of this paper is to review and describe the characteristics and outcomes of ethics consultations on a gastrointestinal oncology service and to identify areas for systems improvement and staff education. This is a retrospective case series derived from a prospectively-maintained database of the ethics consultation service at Memorial Sloan Kettering Cancer Center. The study analyzed all ethics consultations requested for patients on the gastrointestinal medical oncology service from September 2007 to January 2016. A total of 64 patients were (...) identified. The most common primary ethical issue was the DNR order, followed by medical futility. The most common contextual issues were dispute/conflict between staff and family, dispute/conflict intra-family, and cultural/ethnic/religious issues. The majority of ethical issues leading to consultation were resolved ; i.e., the patient, surrogate, and/or healthcare team followed the recommendation of the ethics consultant. 22% had a DNR order prior to the ethics consult and 69% had a DNR order after the consult. In this population of patients on a gastrointestinal oncology service, ethics consultations are most often called regarding patients with advanced cancers and the most common ethical conflicts arose between families and the health care team over goals of care at the end of life, specifically related to the DNR order and perceived futility of continued/escalation of treatment. Ethics consultations assisted with conflict resolution. Conflicts might be reduced with improved communication about prognosis and earlier end of life care planning. (shrink)

Healthcare environments continue to prove discriminatory and marginalizing towards patients and healthcare workers themselves, which contributes to inequitable health outcomes across lines of socially constructed difference. This content and discourse analysis of nursing identity scholarship asks whether there is a connection between nursing identity and oppressive behaviour by examining the construction of nursing identity and the foundational discourses, sometimes in absentia, that support such a construction. Bourdieu's concepts of social fields and Audre Lorde's concept of the master's house are applied (...) as a framework towards understanding the constructs of power and status in healthcare. The analysis identifies a gap in nursing identity literature where social constructs of difference are not considered. In the reviewed literature, nursing identity has been co‐opted by the professionalization project in effort to stabilize a conceptualization of nursing's contribution to healthcare towards gaining professional and societal status. This leads to a monolithic, apolitical representation of nursing identity that erases difference, denies historical influence, universalizes nursing work and further marginalizes marginalized identities. The oppressive and hegemonic nature of a universal nursing identity may contribute to a lack of disciplinary reflexivity about the ongoing influences of foundational discursive constructs of gender, epistemology, power and professional status. (shrink)

A post-modernist analysis of human-centred technology (HCT) suggests the ideology which informs the theoretical and practical development of HCT resonates with ideological representations of machine intelligence portrayed in science fiction (sf) films. It is argued that such an ideology reflects and reinforces ontological dualisms which constrain our ability to imagine and realise our future relations with technology. This paper invites proponents of HCT to meet their shadows, to transgress, the cultural and discursive borders constructed in the name of modernism, and (...) to reflect on what is taken-for-granted and peripheralised within their own work. (shrink)

OBJECTIVE: To ascertain attitudes to different methods of obtaining informed consent for randomised clinical trials (RCTs). DESIGN: Structured interviews with members of the public, medical secretaries and medical students. SETTING: The public were approached in a variety of public places. Medical secretaries and students were approached in their place of work. SUBJECTS: Fifty members of the public, 25 secretaries and 25 students. MAIN OUTCOME MEASURES: Views on RCTs were elicited, with particular emphasis on how subjects thought the concept of randomisation (...) should be explained. Each participant was presented with descriptions of proposed clinical trials and asked to select his or her preference from a range of options. RESULTS: Written information was preferred over verbal information in 91% of replies. Most respondents (86%) would prefer to sign a consent form. Of the seven statements explaining randomisation, a significant difference was found in favour of explanations that were less explicit about the play of chance (ANOVA; p = 0.0004). Eighty-three per cent of participants thought that randomised trials were morally acceptable when there was no prior medical preference between treatments. However, over half (55%) thought they would find it upsetting to be offered entry in such a trial and a quarter thought the outcome of treatment might be adversely affected. CONCLUSIONS: Our results offer some support for the idea that "economy with truth" is less unsettling than a frank description of the stark reality of what randomisation means. It is a matter of debate as to whether, if we are correct, autonomy should have precedence over beneficence. The offer of entry in a clinical trial is likely to affect the experience of care for many people, especially if the process of randomisation is described explicitly. Potential participants should be given a detailed written explanation of the rationale for the trial and be asked to sign a consent form if they agree to take part. (shrink)