This paper is going to explore the adverse effects of exposure to combat death on medics’ holistic well-being, which, if ignored could decrease individual readiness and negatively impact the mission. We rely on the experience of United States Air Force Special Operation Surgical Teams (AF SOST) whose exposure to mass casualty scenarios in austere environments could serve as approximations of conditions of future battlefields. Over the past two decades, the ability to deliver advanced medical care on and off the battlefield (...) along with a rapid casualty evacuation platform has allowed for unprecedented survival rates exceeding 90%. While laudable, these medical achievements have also set up a casualty management paradigm in which medical decision-making singularly focuses on life-saving care. Confronting peer-peer adversaries in large scale combat operations (LSCO) on a multi-domain battlefield will make casualty management frighteningly more complex by introducing major infrastructural, personnel, and resource constraints. When considering the high number of casualties expected in LSCO alongside enormous limitations in medical resource and resupply capability, the current casualty management paradigm will not be sustainable. The resource constrained environment in LSCO will shift medical decision-making away from a singular focus on life-saving care to triage, which hinges on the ability to determine futile medical interventions—a skill that has been lost in the past two generation of combat medics. As such, a broad ethical challenge that arises in preparation for LSCO is the need to set new expectations concerning dying and death. However, medical decision-making focused on death and dying has not been explicitly addressed in military medical training, research, or policy. Relying on a body of literature known as terror management theory (TMT) and ethnographic data from our study with AF SOST medics, we are going to argue that it is important to expose medics to death in mass casualty and triage training. (shrink)

Establishing the basic knowledge, methodology, and technology for a framework for the continuous decoding of hand/arm movement intention was the aim of the ERC-funded project “Feel Your Reach”. In this work, we review the studies and methods we performed and implemented in the last 6 years, which build the basis for enabling severely paralyzed people to non-invasively control a robotic arm in real-time from electroencephalogram. In detail, we investigated goal-directed movement detection, decoding of executed and attempted movement trajectories, grasping correlates, (...) error processing, and kinesthetic feedback. Although we have tested some of our approaches already with the target populations, we still need to transfer the “Feel Your Reach” framework to people with cervical spinal cord injury and evaluate the decoders’ performance while participants attempt to perform upper-limb movements. While on the one hand, we made major progress towards this ambitious goal, we also critically discuss current limitations. (shrink)

Perceived behavioral integrity involves the employee’s perception of the alignment of the manager’s words and deeds. This meta-analysis examined the relationship between perceived behavioral integrity of managers and the employee attitudes of job satisfaction, organizational commitment, satisfaction with the leader and affect toward the organization. Results indicate a strong positive relationship overall (average r = 0.48, p<0.01). With only 12 studies included, exploration of moderators was limited, but preliminary analysis suggested that the gender of the employees and the number of (...) levels between the employee and the manager are potential moderators of the relationship. In the current sample of studies, country where the research was conducted did not seem to have any moderating effects. In addition to suggesting further investigation of potential moderators, we call for research that examines the relationship between behavioral integrity and outcomes that include individual behavior and organizational performance. (shrink)

This article explores the theological themes prevalent in the language of anorexia nervosa by briefly exploring extant literature in the field before reporting on the author’s qualitative fieldwork with Christian women with anorexia nervosa. Sufferers, both those from religious and non-religious backgrounds, often convey their understanding of their illness in theological and moral language, using terms such as ‘sin’ and ‘sacrifice’. The use of theological frameworks on ‘Pro-Ana’ internet forums is also considered. The article concludes by considering the implications of (...) this use of theological language for pastoral and chaplaincy care, and argues that highly skilled mental health chaplains would be of benefit to treatment models for anorexia nervosa and that community church leaders can pay a crucial role in long-lasting recovery, particularly for anorexic women who profess a Christian faith. (shrink)

ABSTRACTRumination has long been considered a verbal thought process, though emerging evidence suggests that some individuals dwell on maladaptive imagery. This series of studies evaluated imagery and verbal thought during experimentally induced rumination and distraction. In Study 1, imagery and verbal thought during rumination resulted in similar increases in negative affect. Greater imagery during distraction, on the other hand, was associated with greater decreases in negative affect while verbal thought was not related to affect change. Given that greater verbal thought (...) was reported in the rumination condition and greater imagery was reported in the distraction condition, Study 2 evaluated whether the rumination/distraction induction was confounded by concurrent induction of imagery or verbal thought. The rumination prompts induced both rumination and verbal thought and the distraction prompts induced both distraction and imagery. Using a revised induction, Study 3 tested whether imagery and verbal t... (shrink)

Consensus around what constitutes researcher conflicts of interest (COIs) and awareness of their influence on our research are two critical steps in ensuring the integrity of our science. In this research, data were collected from individual scholars via 2 surveys 5 years apart and from journals and associations to examine the level of social consensus and moral awareness among scholars, journals, and associations regarding researcher COIs. Although we observed increases in level of social consensus and moral awareness between 2012 and (...) 2017, results still revealed limited agreement about what relationships constitute a COI and limited awareness about the presence of and the ethical issues surrounding COIs. Although all journals and associations we examined supported COI disclosure, most did not provide researchers with detailed COI-related information, guidance, or disclosure tools. Limited social consensus and moral awareness regarding COIs is problematic because it inhibits the recognition, disclosure, and management of COIs and limits ethical decision making. We need to continue and enhance discussions about COIs and aim to create consensus and awareness where we do not have it with the goal of reducing potential scientific misconduct related to COIs. (shrink)

Both unipolar and bipolar depression have been linked with impairments in executive functioning. In particular, mood symptom severity is associated with differences in common EF, a latent measure of general EF abilities. The relationship between mood disorders and EF is particularly salient in adolescence and young adulthood when the ongoing development of EF intersects with a higher risk of mood disorder onset. However, it remains unclear if common EF impairments have associations with specific symptom dimensions of mood pathology such as (...) blunted positive affect, mood instability, or physiological arousal, or if differences in common EF more broadly relate to what is shared across various symptom domains, such as general negative affect or distress. To address this question, bifactor models can be applied to simultaneously examine the shared and unique contributions of particular mood symptom dimensions. However, no studies to our knowledge have examined bifactor models of mood symptoms in relation to measures of common EF. This study examined associations between common EF and general vs. specific symptom dimensions using structural equation modeling in adolescents and young adults with varying severity of mood symptoms. A General Depression factor capturing shared variance across symptoms statistically predicted lower Common EF. Additionally, a factor specific to physiological arousal was associated with lower Common EF. Anhedonia-specific and Mania-specific factors were not significantly related to Common EF. Altogether, these results indicate that deficits in common EF are driven by, or reflect, general features of mood pathology that are shared across symptom dimensions but are also specifically associated with physiological arousal. (shrink)

This essay reports on phenomenological research conducted with people who describe having been harassed, having been accused of harassment, and/or having mediated or adjudicated harassment disputes. The authors review recent legal conceptions of sexual harassment and articulate a methodology for analyzing individual narrative accounts. The analysis of six selected interviews (three alleged harassers and three declared harassees) depicts how, through discourse with others, persons in ambiguous cases of harassment come to perceive themselves as harassers or harasseesgradually, how intention is inferred (...) from conductcontingently, and how perceptions and expressions are often reified as certainties in the effort to secure some sense of justiceinstitutionally. (shrink)

This essay is composed of five stories written by practicing physicians about their patients. Each clinical story describes a challenging ethical condition–potential abuse of medical power, gravely ill and probably over-treated newborns, iatrogenic narcotic addiction, deceived dying people. Rather than singling out one ethical conflict to resolve or adjudicate, the authors attempt, through literary methods, to grasp the singular experiences of their patients and to act according to the deep structures of their patients' lives. Examining these five stories with simple (...) literary tools–attention to narrative frames, time, plot, and desire–reveals the mechanisms through which acts of writing and reading contribute to clinical clarity and ethical actions. (shrink)

Freely falling point-like objects converge toward the center of the Earth. Hence the gravitational field of the Earth is inhomogeneous, and possesses a tidal component. The free fall of an extended quantum mechanical object such as a hydrogen atom prepared in a high principal-quantum-number state, i.e. a circular Rydberg atom, is predicted to fall more slowly than a classical point-like object, when both objects are dropped from the same height above the Earth’s surface. This indicates that, apart from transitions between (...) quantum states, the atom exhibits a kind of quantum mechanical incompressibility during free fall in inhomogeneous, tidal gravitational fields like those of the Earth.A superconducting ring-like system with a persistent current circulating around it behaves like the circular Rydberg atom during free fall. Like the electronic wavefunction of the freely falling atom, the Cooper-pair wavefunction is quantum mechanically incompressible. The ions in the lattice of the superconductor, however, are not incompressible, since they do not possess a globally coherent quantum phase. The resulting difference during free fall in the response of the nonlocalizable Cooper pairs of electrons and the localizable ions to inhomogeneous gravitational fields is predicted to lead to a charge separation effect, which in turn leads to a large Coulomb force that opposes the convergence caused by the tidal gravitational force on the superconducting system.A “Cavendish-like” experiment is proposed for observing the charge separation effect induced by inhomogeneous gravitational fields in a superconducting circuit. The charge separation effect is determined to be limited by a pair-breaking process that occurs when low frequency gravitational perturbations are present. (shrink)

Following the landmark corporate scandals of the early 21st century, there appeared to be a tremendous increase in the U.S. business media's emphasis on issues of ethics in corporate leadership. The purpose of this research was to examine whether that apparent increase was reflected in an actual change in that media's portrayals of successful leaders. We content analyzed the text of a total of 180 articles in Business Week, Fortune, and Forbes magazine, 90 from the five years preceding the landmark (...) scandals and 90 from the five years following the scandals. We found no evidence that the landmark scandals had any impact on the media's incorporation of ethics in their portrayals of leaders. We attribute this substantially to the persistence of a world-view in the U.S. business press that emphasizes leader traits and actions that have a direct impact on corporate profits. Additionally, we found some interesting consistencies and differences in media portrayals across the two time periods, likely related to the rise and fall of dot-com businesses. We discuss the implications of these findings for researchers and corporate leaders. (shrink)

In this article, we scrutinize views that justify exclusionary policies regarding transgender athletes based primarily on physiological criteria. We introduce and examine some elements that deserve...

The distinctive security features of the Spanish electronic national identity card, known as Documento Nacional de Identidad electrónico, allow us to propose the usage of this cryptographic smart card in an authentication framework that can be used during the registration and login phases of internet services where the validation of the user’s age and real identity are key elements, as it is the case for example of the so-called social networks. Using this mechanism with NFC-capable devices, the identity and age (...) of the potential user can be determined, allowing or denying the access to the service based on that information. (shrink)

The problem of knowledge evolution has received considerable attention over the years. Mainly, the study of the dynamics of knowledge has been addressed in the area of Belief Revision, a field emerging as the convergence of the efforts in Philosophy, Logic, and more recently Computer Science, where research efforts usually involve “flat” knowledge bases where there is no additional information about the formulas stored in it. Even when this may be a good fit for particular applications, in many real-world scenarios (...) different information items may be attached to formulas. For instance, when the reliability of the source of the piece of information is attached to it as a measure of some quality (e.g., strength) of the piece of information itself, or when some characteristic informs us on the desirability of the item (e.g., the potential benefit that could be obtained from it). If this type of information is available, we can use it to guide how the belief base is to be modified when new information arrives. In this work, we present a novel approach to the contraction of knowledge bases where formulas have values attached that measure some quality linked to those formulas, exploiting it to define their desirability, and uses such desirability to define which formulas need to be removed to solve conflicts. In this context, we introduce a set of properties for contraction operators by extending classic approaches. We also show how the local treatment of minimal conflicts can induce some counter-intuitive contractions, and we present a way to avoid them by considering optimal resolutions of conflicts using the additional information encoded. We show how the proposed formalization captures any contraction that is optimal under a set of features. Finally, we present a refinement based on the identification of related minimal conflicts that performs contraction in optimal ways without looking into the entire knowledge base. The approach is based on the use of the accrual of beliefs where several formulas collaboratively use their respective values to prevail in the resolution of conflicts. (shrink)

Cultural effects can influence the results of causal genetic analyses, such as Mendelian randomisation, but the potential influences of culture on genotype–phenotype associations are not currently well understood. Different genetic variants could be associated with different phenotypes in different populations, or culture could confound or influence the direction of the association between genotypes and phenotypes in different populations.

We agree that treating rules and similarity as dichotomous opposites is unproductive. However, describing all categorization operations as a continuum of varied similarity process obscures a multidimensional contrast. We describe two processes, instantiated rules and abstract analogy, both of which have aspects of rules and similarity, and question whether they can be compared informatively as points on a continuum.

Cooperative, connected and automated mobility technologies have the potential to revolutionize transportation systems and enhance safety, efficiency and sustainability. However, the increasing reliance on digital technologies also introduces new cybersecurity risks that can compromise the safety and privacy of passengers and the integrity of transportation systems. The purpose of this article is to examine the most important threats, vulnerabilities, risks and challenges related to automated mobility and to review the status of the most promising standardization initiatives on cryptography in a (...) world where quantum computers will soon represent an actual threat. (shrink)

BackgroundAlthough patient advocates have developed templates for standard consent forms, evaluating patient preferences for first in human (FIH) and window of opportunity (Window) trial consent forms is critical due to their unique risks. FIH trials are the initial use of a novel compound in study participants. In contrast, Window trials give an investigational agent over a fixed duration to treatment naïve patients in the time between diagnosis and standard of care (SOC) surgery. Our goal was to determine the patient-preferred presentation (...) of important information in consent forms for these trials.MethodsThe study consisted of two phases: (1) analyses of oncology FIH and Window consents; (2) interviews of trial participants. FIH consent forms were analyzed for the location(s) of information stating that the study drug has not been tested in humans (FIH information); Window consents were analyzed for the location(s) of information stating the trial may delay SOC surgery (delay information). Participants were asked about their preferred placement of the information in their own trial’s consent form. The location of information in the consent forms was compared to the participants’ suggestions for placement. Results34 [17 FIH; 17 Window] of 42(81%) cancer patients approached participated. 25 consents [20 FIH; 5 Window] were analyzed. 19/20 FIH consent forms included FIH information, and 4/5 Window consent forms included delay information. 19/20(95%) FIH consent forms contained FIH information in the risks section 12/17(71%) patients preferred the same. Fourteen (82%) patients wanted FIH information in the purpose, but only 5(25%) consents mentioned it there. 9/17(53%) Window patients preferred delay information to be located early in the consent, before the “Risks” section. 3/5(60%) consents did this.ConclusionsDesigning consents that reflect patient preferences more accurately is essential for ethical informed consent; however, a one-size fits all approach will not accurately capture patient preferences. We found that preferences differed for FIH and Window trial consents, though for both, patients preferred key risk information early in the consent. Next steps include determining if FIH and Window consent templates improve understanding. (shrink)

Volume 20, Issue 2, February 2020, Page 1-4.

Genomic research—including whole genome sequencing and whole exome sequencing—has a growing presence in contemporary biomedical investigation. The capacity of sequencing techniques to generate results that go beyond the primary aims of the research—historically referred to as “incidental findings”—has generated considerable discussion as to how this information should be handled—that is, whether incidental results should be returned, and if so, which ones.Federal regulations governing most human subjects research in the United States require the disclosure of “the procedures to be followed” in (...) the research as part of the informed consent process. It seems reasonable to assume—and indeed, many commentators have concluded—that genomic investigators will be expected to inform participants about, among other procedures, the prospect that incidental findings will become available and the mechanisms for dealing with them. Investigators, most of whom will not have dealt with these issues before, will face considerable challenges in framing meaningful disclosures for research participants.To help in this task, we undertook to identify the elements that should be included in the informed consent process related to incidental findings. We did this by surveying a large number of genomic researchers (n = 241) and by conducting in‐depth interviews with a smaller number of researchers (n = 28) and genomic research participants (n = 20). Based on these findings, it seems clear to us that routine approaches to informed consent are not likely to be effective in genomic research in which the prospect of incidental findings exists. Ensuring that participants’ decisions are informed and meaningful will require innovative approaches to dealing with the consent issue. We have identified four prototypical models of a consent process for return of incidental findings. (shrink)

There has recently been a reappraisal of value in UK construction and calls from a wide range of influential individuals, professional institutions and government bodies for the industry to exceed stakeholders’ expectations and develop integrated teams that can deliver world class products and services. As such value is certainly topical, but the importance of values as a separate but related concept is less well understood. Most construction firms have well-defined and well-articulated values, expressed in annual reports and on websites; however, (...) the lack of rigorous and structured approaches published within construction management research and the practical, unsupported advice on construction institution websites may indicate a shortfall in the approaches used. This article reviews and compares the content and␣structure of some of the most widely used values approaches, and discusses their application within the construction sector. One of the most advanced and empirically tested theories of human values is appraised, and subsequently adopted as a suitable approach to eliciting and defining shared organisational values. Three studies within six construction organisations demonstrate the potential application of this individually grounded approach to reveal and align the relative values priorities of individuals and organisations to understand the strength of their similarity and difference. The results of these case studies show that this new universal values structure can be used along with more qualitative elicitation techniques to understand organisational cultures. (shrink)

The nonlinear differential equation governing the periodic motion of the one-dimensional, undamped, and unforced cubic-quintic Duffing oscillator is solved exactly by obtaining the period and the solution. The period is given in terms of the complete elliptic integral of the first kind and the solution involves Jacobian elliptic functions. We solve the cubic-quintic Duffing equation under arbitrary initial conditions. Physical applications are provided. The solution to the mixed parity Duffing oscillator is also formally derived. We illustrate the obtained results with (...) concrete examples. We give high accurate trigonometric approximations to the Jacobian function cn. (shrink)