Diseases causing inherited retinal degeneration in humans, such as retinitis pigmentosa and macular dystrophy, are genetically heterogeneous and clinically diverse. More than 40 genes causing retinal degeneration have been mapped to specific chromosomal sites; of these, at least 10 have been cloned and characterized. Mutations in two proteins, rhodopsin and peripherin/RDS, account for approximately 35% of all cases of autosomal dominant retinitis pigmentosa and a lesser fraction of other retinal conditions. This target article reviews the genes and mutations causing retinal (...) degeneration and proposes mechanisms whereby specific mutations lead to particular clinical consequences, that is, the relationship between genotype and phenotype. Retinitis pigmentosa and macular dystrophy are genetically heterogeneous diseases that cause retinal degeneration in humans and often result in severe visual impairment or blindness. Although many of the genes causing these diseases have not been identified, three photoreceptor-specific proteins have been implicated: rhodopsin, peripherin/RDS, and the P-subunit of rod phosphodiesterase. Mutations in the genes for these three proteins can cause either dominant retinitis pigmentosa, recessive retinitis pigmentosa, dominant congenital stationary night blindness, or dominant macular degeneration. Why this multiplicity of clinical phenotypes? Our target article summarizes the genetic and biochemical background to this question and proposes a number of possible explanations. Discussion focuses mainly on 73 distinct disease-causing mutations of rhodopsin. We feel that rhodopsin and other photoreceptor proteins can serve as model systems for unraveling the connection between genotype and phenotype, not only for inherited retinal diseases but for other degenerative disorders as well. (shrink)

Recent findings emphasize the complexity, both genetic and functional, of the manifold genes and mutations causing inherited retinal degeneration in humans. Knowledge of the genetic bases of these diseases can contribute to design of rational therapy, as well as elucidating the function of each gene product in normal visual processes.

This article aims to focus on how signatories versus nonsignatories in the U.S. pharmaceutical sector compare with respect to the internal and external stakeholders and principles of the United Nations Global Compact (UNGC). We seek to answer the question: Do signatories to the UNGC walk the talk better than nonsignatories as determined by a variety of published rankings and data? This research presents an innovative approach to the evaluation of UNGC signatories. It uses several objective and independent data sources to (...) assess a matched group of signatories versus nonsignatories in the U.S. pharmaceutical sector. Signatory organizations in the same sector as determined by SIC codes were matched with nonsignatories on variables such as size and number of employees in U.S. pharmaceutical companies. Then both types of organizations were compared on the following data sources: Coalition for Environmentally Responsible Economies ratings, ratings by external stakeholders, ratings by employees, unionization data, financial measures, and annual reports to shareholders. Using nonparametric testing the research found there are differences between signatories and nonsignatories in the U.S. pharmaceutical sector for some of the external stakeholder measures and no differences were found for the internal stakeholder measures. (shrink)

This study examines the theory of planned behavior and the multidimensional ethics scale. Variables from both are included to determine which ones significantly correlate with student ethical behavioral intention in an academic setting. Using a survey, responses are collected from undergraduate business students from two southwestern universities in the United States using a scenario-based approach, looking at individual situations and group situations. SmartPLS was used to assess the results for four scenarios. From the theory of planned behavior, attitude was a (...) significant predictor of behavioral intention across all four scenarios while subjective norm was significant in one scenario. From the multidimensional ethics scale, moral equity and relativism were significant in one group scenario while moral equity and utilitarianism were each significant in an individual scenario. The findings indicate support for the use of the TPB and the MES when exploring ethics in an academic setting and for the need to study both individual and group situations. A discussion of the findings and implications is given. (shrink)

: Because an influenza pandemic would create the most serious hardships for those who already face most serious hardships, countries should take special measures to mitigate the effect of a pandemic on existing social inequalities. Unfortunately, there is little evidence that anybody is thinking about that.

This study examines business students’ ethical awareness for two virtues needed to maintain academic integrity, respect, and responsibility. Using the multidimensional ethics survey, five dimensions were measured for six scenarios representing student behaviors using Information Technology . The results indicate that students are ethically aware in respect situations, but are more neutral in responsibility situations. Of the five ethical dimensions, moral equity and relativism appear to be the strongest influences in academic integrity scenarios utilizing IT. This study provides guidance for (...) business professors in their pursuit of ethical excellence in the classroom and for researchers in search of greater understanding of ethical judgments of students. (shrink)

Consciousness, understood as an awareness of what is going on that helps shape one’s experiences, is one of the ways that scholars have distinguished animal life from the rest of the natural world. Beings that have interests in having good experiences and avoiding bad ones deserve our moral attention, and this quality is an important feature of ethical engagement with other sentient beings, both human and nonhuman. What interests matter and why they matter is a subject of disagreement that has (...) affected what we judge to be permissible or impermissible treatment of other animals. Empathy toward and respect for other animals takes us beyond attention to their suffering and has us focus on what counts as well-being for others, by their own lights. (shrink)

Agitation is one of the most common behavioural and psychological symptoms in people living with dementia. This behaviour can cause tremendous stress and anxiety on family caregivers and healthcare providers. Direct observation of PLwD is the traditional way to measure episodes of agitation. However, this method is subjective, bias-prone and timeconsuming. Importantly, it does not predict the onset of the agitation. Therefore, there is a need to develop a continuous monitoring system that can detect and/or predict the onset of agitation. (...) In this study, a multi-modal sensor platform with video cameras, motion and door sensors, wristbands and pressure mats were set up in a hospital-based dementia behavioural care unit to develop a predictive system to identify the onset of agitation. The research team faced several barriers in the development and initiation of the study, namely addressing concerns about the study ethics, logistics and costs of study activities, device design for PLwD and limitations of its use in the hospital. In this paper, the strategies and methodologies that were implemented to address these challenges are discussed for consideration by future researchers who will conduct similar studies in a hospital setting. (shrink)

Personal Versus Political Affairs in Churchill's This is a Chair There are plenty of issues in the world to petition and fight for, yet each individual also has "battles" at home to contend with. Which is of more importance? We often separate the two indefinitely. In studying Caryl Churchill's work This Is a Chair, however, I would suggest the personal and political to be intimately related and possibly each even a causation of the other. To take care of one may (...) be eliminating the problem of the other as well. Might political problems stem from petty, personal qualms? Even more specifically might jeopardizing moral norms affect the greater social order? If so, this would be a revelation and fresh pursuit in solving many of the monumental political issues which are faced today. (shrink)

Capability approach pioneers Amartya Sen and Martha Nussbaum both recognize empowerment as an important aspect of human development. They seem to disagree, however, about how empowerment should be represented within the capability approach (CA). This essay is concerned with the analysis of the foundational concepts at work within Sen and Nussbaum’s CAs. Part One concerns the key concepts of empowerment at work in Sen’s CA and has three goals. 1) Clarify Sen’s various empowerment concepts. 2) Argue that Sen’s concept of (...) Realize Agency Success is flawed. 3) Make clear that empowerment in Sen’s approach can be helpfully understood in terms of agency and capability set expansion. Part Two considers Nussbaum’s CA and the debate over whether it can account for empowerment. I conclude that not only can Nussbaum’s CA account for empowerment, but that the role of empowerment in both Sen’s and Nussbaum’s CAs can be understood in terms of agency and capability set expansion. In other words, Sen and Nussbaum actually agree about empowerment at the foundational level. (shrink)

Notion essentielle au croisement de la psychologie, de l'ethique et de l'esthetique de la tradition occidentale, la phantasia des Grecs, devenue imaginatio dans le monde latin avant d'etre traduite dans les differentes langues europeennes, a connu un echo considerable tout au long de l'histoire de la pensee philosophique. Les etudes rassemblees dans le present volume sont issues d'un seminaire et d'une journee d'etudes qui se sont tenus en 2001 a l'Universite catholique de Louvain et aux Facultes Notre-Dame de la Paix (...) de Namur. Elles visent a eclairer l'evolution du sens et du role de la notion au travers d'etapes historiques particulieres, surtout anciennes, s'echelonnant du VIe siecle avant Jesus-Christ au XVIIe siecle de notre ere. (shrink)

Dix ans apres la mort de Hans Jonas, qu'en est-il de la reception de sa philosophie? L'incroyable succes qu'elle connut s'explique par l'actualite d'un de ses themes principaux: la necessite d'une responsabilite nouvelle a l'egard des generations futures. Mais la reception largement negative que provoqua sa vulgarisation dans les domaines de l'ethique envireonnementale ou de la bioethique ne laisse pas de masquer le fondement de cette philosophie et les conditions memes de la mise en place des thematiques nouvelles qui retinrent (...) d'abord l'attention. S'alimentant a des sources tantot cachees, tantot eclectiques, elle s'est developpee au cours de plusieurs periodes dont le philosophe lui-meme disait ne pas voir ce qu'elles avaient en commun... Susceptible d'etre abordee par des voies multiples, cette oeuvre reste encore un defi pour le penseur et l'historien de la philosophie qui veulent la prendre au serieux et qui sont soucieux de la reconstruire et d'en lever tous les mysteres. (shrink)

BackgroundMedical aid in dying was introduced in Quebec in 2015. Quebec clinical guidelines recommend that MAiD be approached as a last resort when other care options are insufficient; however, the law sets no such requirement. To date, little is known about when and how requests for MAiD are situated in the broader context of decision-making in end-of-life care; the timing of MAiD raises potential ethical issues.MethodsA retrospective chart review of all MAiD requests between December 2015 and June 2017 at two (...) Quebec hospitals and one long-term care centre was conducted to explore the relationship between routine end-of-life care practices and the timing of MAiD requests.ResultsOf 80 patients requesting MAiD, 54% received the intervention. The median number of days between the request for MAiD and the patient’s death was 6 days. The majority of palliative care consults came less than 7 days prior to the MAiD request and in another 25% of cases occurred the day of or after MAiD was requested. 35% of patients had no level of intervention form, or it was documented as 1 or 2 at the time of the MAiD request and 19% were receiving life-prolonging interventions.InterpretationWe highlight ethical considerations relating to the timing of MAiD requests within the broader context of end-of-life care. Whether or not MAiD is conceptualised as morally distinct from other end-of-life options is likely to influence clinicians’ approach to requests for MAiD as well as the ethical importance of our findings. We suggest that in the wake of the 2015 legislation, requests for MAiD have not always appeared to come after an exploration of other options as professional practice guidelines recommend. (shrink)

In the context of the worsening economic crisis analogies tend to be drawn between the economic and political crisis in Europe of the 1920s and 1930s and the current situation. Now as then, it is argued, there is the risk that a systemic economic crisis and the crisis of representative politics will in turn lead to authoritarian outcomes. Rarer, however, is the idea that the current political and economic crisis may lead to a “progressive” outcome. This article examines both options (...) under the light of the thinking of one of the most important interpreters of political crisis and change in the 1920s and 1930s: Antonio Gramsci. One of the central arguments in Gramsci’s Prison Notebooks is the crisis of parliamentarism and democratic politics. Gramsci did not limit his analysis to the crisis however. His theoretical undertaking also consisted in the attempt to imagine the conditions for moving beyond the democratic crisis in a progressive manner. What emerges is an existing continuity between the Gramscian categories of Cesarism-Bonapartism, economic-corporative State, hegemonic crisis and contemporary politics, particularly with reference to phenomena such as populism, technocracy and neo-liberalism; the utility of the conceptual category of Passive Revolution to comprehend the current forms of exerting power and building social consent; the potential fruitfulness of Gramsci’s schemata on counter-hegemonies, to understand the changes in the party-organization and the possibilities of building counter-hegemonies. (shrink)

Working in and around the ‘chain of command’: power relations among nursing staff in an urban nursing homeBy most accounts, the discipline of nursing enjoys considerable hegemony in US nursing homes. Not surprisingly, the ethos of this setting is influenced, in large part, by nursing’s value system. This ethos powerfully impacts both the residents who live in nursing homes and the staff who work there. Using ethnographic methods, this project explored power relations among nursing assistants and nurses in an urban (...) nursing home in the United States. Factors contributing to tensions among nursing staff were the stigma attached to nursing homes and those who work in them, as well as the long history of class conflict and power struggles within the discipline of nursing. The latter struggles, in turn, reflected nursing’s quest for professional status in the face of medicine’s hegemony over health‐care. Ultimately, these factors coalesced to produce a local work environment characterized by conflict — and by aides’ resistance to nurses’ domination. (shrink)

Recent research indicates that among young women, Blacks have lower employment rates than whites. Evidence is provided about whether young Black women's lower employment rates stem from structural features of the labor market, discrimination, or changing family or individual characteristics. Data show that Black women exit full-time employment at higher rates because they are more likely to be laid off, to leave because they work in temporary/seasonal jobs, and to leave for other reasons. Structural features of the labor market are (...) key in explaining Black women's higher rates of lay-offs, exits from temporary/seasonal work, and exits for other reasons. Individual characteristics and discrimination play a role in Black women's higher rates of lay-offs and exits for other reasons while family characteristics are important in explaining Black women's higher rates of leaving temporary/seasonal work and leaving for other reasons. Evidence suggests that Black women's higher exit rates are indicative of disadvantage in the labor market. (shrink)

This paper describes how I came to know a younger, mentally ill resident during fieldwork in an urban nursing home. I describe my efforts to establish a connection with this man, revealing the manner in which the academic and personal become fused in ethnographic research. In his discourse David conveys an unsettling universe filled with extreme power asymmetries, where he continually gravitates between the roles of victim and victimizer. His various identities are in a state of constant flux, at times (...) blurring the boundaries of culturally recognized categories. While fragmentation and multiplicity are often glorified within postmodernism, I suggest that persons with psychosis may find them imprisoning rather than liberating. (shrink)

Industry groups engage in venue shifting when they seek to overturn or alter restrictive regulations imposed by one political venue through another. A critical step in this process is resolving uncertainties surrounding the preference of the targeted venue and the nature of the relevant policy proposal. While existing studies emphasize a long-term trial-and-error process of policy learning, we focus on nascent industries and argue that ventures seek other information sources to resolve these uncertainties quickly. In particular, nascent industry groups are (...) likely to perceive that the targeted venue will support their policy proposal if the targeted venue is ideologically distant from the venue that has enacted the restrictive regulations, if the targeted venue has recently supported other nascent industry groups’ similar policy proposals, or if the industry groups themselves are more exposed to industry peers’ success in promoting the same policy proposal in other jurisdictions. Under these conditions, the industry groups invest more to influence the targeted venue in response to restrictive regulations enacted by other venues. We find support for our theory by examining how from 2013 to 2019 the small unmanned aircraft systems industry trade associations in the United States lobbied state governments to nullify local regulations. (shrink)

In _Politics with Beauvoir_ Lori Jo Marso treats Simone de Beauvoir's feminist theory and practice as part of her political theory, arguing that freedom is Beauvoir's central concern and that this is best apprehended through Marso's notion of the encounter. Starting with Beauvoir's political encounters with several of her key contemporaries including Hannah Arendt, Robert Brasillach, Richard Wright, Frantz Fanon, and Violette Leduc, Marso also moves beyond historical context to stage encounters between Beauvoir and others such as Chantal Akerman, (...) Lars von Trier, Rahel Varnhagen, Alison Bechdel, the Marquis de Sade, and Margarethe von Trotta. From intimate to historical, always affective though often fraught and divisive, Beauvoir's encounters, Marso shows, exemplify freedom as a shared, relational, collective practice. _Politics with Beauvoir_ gives us a new Beauvoir and a new way of thinking about politics—as embodied and coalitional. (shrink)

In the Italian national elections in 2013, the Movimento Cinque Stelle, founded just four years earlier, gained 25 percent of votes, more than any other party. Analyses and interpretations are divided between those who consider M5S a member of the family of European populism and those who see M5S’s propositions as akin to the values of the left and social movements. The debate on M5S fits into the context of important ongoing trends in European politics: the growth of populist political (...) movements; the emergence of outsider parties able to challenge stable political systems; changing relationships between parties and social movements; changes in the forms of political organizing. This article investigates the political and cultural nature of this party by analyzing its discourse on democracy, its organizational choices and its main issues; comparing these elements with populism and the left; and linking its fundamental characteristics to contemporary economic processes usually termed “digital capitalism.”. (shrink)

The impact of Darwin's work in biology is widely known; we present here a less known aspect which is that of applying Darwin's ideas in physics, and how this may relate with the transition from pre-life to life. Darwin's work on the origin of species was a breakthrough not only because of its explanation of how different species came to exist but also because the extinction of a species is caused not only by the charactenstics of the species, but in (...) large degree by the charactenstics of the environment. In contrast, in Newton's approach to physics, the environment was seen as neutral and inert. The goal of this article is to portray how quantum Darwinism helps to clarify the transition from Physics to pre-life. (shrink)

In this comprehensive introduction to animal ethics, Lori Gruen weaves together poignant and provocative case studies with discussions of ethical theory, urging readers to engage critically and empathetically reflect on our treatment of other animals. In clear and accessible language, Gruen provides a survey of the issues central to human-animal relations and a reasoned new perspective on current key debates in the field. She analyses and explains a range of theoretical positions and poses challenging questions that directly encourage readers (...) to hone their ethical reasoning skills and to develop a defensible position about their own practices. Her book will be an invaluable resource for students in a wide range of disciplines including ethics, environmental studies, veterinary science, women's studies, and the emerging field of animal studies and is an engaging account of the subject for general readers with no prior background in philosophy. (shrink)

Integral human development is a human-centered development perspective that originated from Catholic social teaching. The perspective holds that authentic development is development that makes every person “more human.” Although it is seldom named in the literature, integral human development has had considerable influence on notions of authentic development, and in turn, development ethics. In this short chapter, I provide a brief explanation of the origins and implications of the conceptual foundations of integral human development both within and beyond the Catholic (...) Church. I argue that integral human development offers a truly radical participatory approach to human development. I briefly raise and respond to some concerns about agency, civic liberty, and integral human development’s connection to the Catholic Church. I conclude with a short explanation of integral human development in practice. (shrink)

The knowledge production of researchers interested in improving the health‐care of young clients through the employment of emancipatory research methodologies may be limited by the complexity that working with young children presents to the research process. The purpose of this paper is to explore whether emancipatory research methodologies have application within the context of research with children. Critical examination of the challenges inherent in emancipatory research with children reveals that the application of aspects of these approaches presents possibilities for contributing (...) significantly to our knowledge development for the nursing of children. (shrink)

John Cassian, an Egyptian monk in the early fifth century offers splendid wisdom and counsel regarding many spiritual disciplines. This reflection describes a personal experience of journeying with Cassian's prayer. In the most frequently quoted excerpt from his Conferences, Cassian raises up a prayer formula using Psalm 70:1 as a verse to facilitate unceasing prayer of the heart: “O God, come to my assistance; Lord, make haste to help me. “ In an unexpected and surprising way, this verse from Psalm (...) 70 comes to appear in the Liturgy of the Hours, as a preamble verse to Morning, Daytime, and Evening Prayer. Over the centuries, this simple verse from the Psalms has carried an entire prayer tradition, rooted in the spirituality of the desert. Cassian's elucidation of this verse reminds us how a formative reading of Scripture is integrally bound to the soul's progress in prayer. (shrink)

Due to COVID-19’s strain on health systems across the globe, triage protocols determine how to allocate scarce medical resources with the worthy goal of maximising the number of lives saved. However, due to racial biases and long-standing health inequities, the common method of ranking patients based on impersonal numeric representations of their morbidity is associated with disproportionately pronounced racial disparities. In response, policymakers have issued statements of solidarity. However, translating support into responsive COVID-19 policy is rife with complexity. Triage does (...) not easily lend itself to race-based exceptions. Reordering triage queues based on an individual patient’s racial affiliation has been considered but may be divisive and difficult to implement. And while COVID-19 hospital policies may be presented as rigidly focused on saving the most lives, many make exceptions for those deemed worthy by policymakers such as front-line healthcare workers, older physicians, pregnant women and patients with disabilities. These exceptions demonstrate creativity and ingenuity—hallmarks of policymakers’ abilities to flexibly respond to urgent societal concerns—which should also be extended to patients of colour. This paper dismantles common arguments against the confrontation of racial inequity within COVID-19 triage protocols, highlights concerns related to existing proposals and proposes a new paradigm to increase equity when allocating scarce COVID-19 resources. (shrink)

Ernst Troeltschs Analysen einer Familien- und Ehe- bzw. Sexualethik einzelner historischer Ausprägungen des Christentums weisen die normativen Bedenken, die sein Werk “Die Soziallehren der christlichen Kirchen und Gruppen” prägen, aus. Im Zuge der Beschreibung der Anschauungen von Geschlecht und Familie, die den jeweiligen Idealtypus von Kirche, Sekte und Mystizismus charakterisieren, untersucht Troeltsch zugleich auch eine zeitgenössische christliche Konzeption von Gleichheit und Ungleichheit, während er konkurrierende Modelle sozialer Beziehung und Organisation kritisch in den Blick nimmt. Zudem sind Troeltschs Gedanken die geschlechterspezifischen (...) Dimensionen eines jeden Idealtypus betreffend von zentraler Bedeutung für eine exakte Bestimmung seiner soziologischen Kategorien und typologischen Unterscheidungen. Sie verdienen darum nicht bloß genauere Beachtung, sondern sind notwendig, will man die gelehrten und politischen Debatten, die Troeltsch als Historiker und Kulturtheoretiker beeinflußten, verstehen. (shrink)

Telling stories after a loved one’s death helps surviving family members to find meaning in the experience and share perceptions about whether the death was consistent with the deceased person’s values and preferences. Opportunities for physicians to evaluate the experience of a patient’s death and to expose the ethical concerns that care for the dying often raises are rare. Narrative medicine is a theoretical perspective that provides tools to extend the benefits of storytelling and narrative sense–making to physicians. This case (...) study describes narrative writing workshops attended by physicians who care for dying patients. The narratives created revealed the physicians’ concerns about ethics and their emotional connection with patients. This case study demonstrates that even one–time reflective writing workshops might create important opportunities for physicians to evaluate their experiences with dying patients and families. (shrink)

We read with interest Lanphier and Anani’s manuscript on trauma-informed ethics consultation. Their model rightly integrates trauma-informed principles within the ethics c...

New Jersey's Baby M case has thrust the issue of surrogate motherhood on state legislatures throughout the country. Like artificial insemination in the 1950s and 1960s, this new reproductive technology is evoking legislative responses ranging from horrified prohibition to cautious facilitation.

This hermeneutic phenomenological study of how remote workers in global corporations experience and interpret local place is based on Heidegger’sthinking about space, place, and dwelling, Giddens’ conception of globalization as “time-space distanciation,” and recent research and theory related to remote work and architecture. Study participants are knowledge workers in the United States and Europe who work full time from home as employees of large global corporations. The analysis reveals several insights about remote workers’ lived experience of place, including the importance (...) of managing the threshold between work and home and the need to create spaces for interaction at work. Some remote workers learn to shape, choose, or create places that better suit them, while others prefer to remain in place. Some become more involved in their local communities, helping these communities become more globally-connected while retaining their unique local qualities. The analysis reveals five themes that suggest that place is both spatial and temporal. A place is a specific location within physical space that acquires personal meaning, arising from a person’s past history and evolving with ongoing or repeated experience. Individuals make meaning of place as Center (groundedness or rootedness), Setting (activity, convenience or purpose), and Source (generativity, inspiration or transcendence). We shape and respond to places; places shape us as our lives take place within them. (shrink)

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Gilles Deleuze and Félix Guattari’s notion of becoming-animal offers a mode of interaction that goes beyond the symbolic language and conceptual thought that are often used in the western philosophical tradition to circumscribe the limits and define the nature of an ethical engagement. They fail, however, to provide a robust account of how becoming may yield an ethical exchange between the human being and the animal other. In order for this process to generate such an outcome, it must be accompanied (...) by commitment to and care for the animal. Primatologist Barbara Smuts brings this becoming to the flesh in ways that enable a committed, caring and collaborative ethical interaction between species. (shrink)

Why are we here? What is the meaning of life? How can we feel happy and free? The answers to these and other life questions are gathered in Tiny Buddha, Simple Wisdom for Life's Hard Questions. Tiny Buddha began as a quote-a-day Twitter account, @tinybuddha, in 2008. Lori Deschene's daily wisdom posts about mindfulness, non-attachment, and happiness became so popular that she now has more than 200,000 twitter followers who share quotes and stories about inspiration in their daily lives.Deschene (...) asked her Twitter followers to contribute their thoughts and perspectives on the difficult questions that influence how we live our everyday lives: thoughts about the meaning of life, pain, happiness, fate, and more.Tiny Buddha, Simple Wisdom for Life's Hard Questions is a combination of the amazing responses that she received along with her own insightful essays, and insights from wise teachers around the world and throughout time. Deschene explores how these issues have played out in her own life and offers action-oriented suggestions to help people empower themselves, even in a world with so much uncertainty. The result is a guide that helps readers discover the endless possibilities for a life lived mindfully in the present, and connected to others. (shrink)