ZusammenfassungSystemmedizinische Ansätze zeichnen sich durch die Integration großer Datenmengen aus vielfältigen Datenquellen aus und führen systembiologische und medizinische Forschungsansätze mit informationswissenschaftlichen Methoden und prädiktiven Verfahren mathematischer Modellierung zusammen. Hieraus resultiert eine enge Kooperation von Ärzten und Naturwissenschaftlern, wobei insbesondere die Expertise nicht-ärztlicher Forscher zunehmend an Bedeutung für die Datenaufbereitung und -interpretation gewinnt. Aus ethischer Perspektive wirft diese Entwicklung Fragen nach der konkreten Gestaltung einer systemmedizinischen Zusammenarbeit sowie möglichen Rollenveränderungen und neuen Verantwortungszuschreibungen an Ärzte und nicht-ärztliche Forscher auf. Um diese Fragen (...) mit Blick auf die Erfahrungen und Perspektiven der beteiligten Akteursgruppen zu beleuchten, führten wir eine qualitative Interviewstudie mit Ärzten und nicht-ärztlichen Forschern aus unterschiedlichen systemmedizinischen Kontexten durch. Aus dem Interviewmaterial ließen sich zwei Konzeptionen von Systemmedizin rekonstruieren. Die erste ist durch eine eindeutige arbeitsteilige Rollentrennung zwischen Ärzten und Forschern charakterisiert: Der Forscher fungiert als Dienstleister, der Arzt als translationaler, interdisziplinär ausgerichteter Mediziner. Die zweite zeichnet sich durch eine weitreichende Aufhebung der Rollentrennung von Ärzten und Forschern aus: Die Berufsgruppen agieren als interdisziplinäres Team mit einer engen wechselseitigen inhaltlichen und methodischen Zusammenarbeit der Akteure. In beiden Konzeptionen werden Rollenkonflikte von Ärzten und Forschern deutlich, die insbesondere auf die Diskrepanz zwischen dem Arzt- und Forscherethos und die mit ihnen je verknüpften spezifischen Handlungsnormen und Ziele zurückzuführen sind. Ferner besteht mit Blick auf die dem Arzt und Forscher jeweils zukommende Verantwortung gegenüber Patienten vielfältiger normativer Klärungsbedarf, insbesondere hinsichtlich der Frage, welche Verantwortung den Akteursgruppen gerechtfertigter Weise zugeschrieben werden kann. Diesbezüglich erscheint eine Differenzierung von versorgungsnäheren und grundlagenforschungsorientierten Arbeitsfeldern angeraten. (shrink)

Working memory is the system responsible for maintaining and manipulating information, in the face of ongoing distraction. In turn, WM span is perceived to be an individual-differences construct reflecting the limited capacity of this system. Recently, however, there has been some evidence to suggest that WM capacity can increase through training, raising the possibility that training can functionally alter the neural structures supporting WM. To address the hypothesis that the neural substrates underlying WM are targeted by training, we conducted a (...) meta-analysis of functional magnetic resonance imaging studies of WM training using Activation Likelihood Estimation. Our results demonstrate that WM training is associated exclusively with decreases in blood oxygenation level-dependent responses in clusters within the fronto-parietal system that underlie WM, including the bilateral inferior parietal lobule, middle and superior frontal gyri, and medial frontal gyrus bordering on the cingulate gyrus. We discuss the various psychological and physiological mechanisms that could be responsible for the observed reductions in the BOLD signal in relation to WM training, and consider their implications for the construct of WM span as a limited resource. (shrink)

Building on existing studies suggesting that corporate social performance (CSP) is important in the job choice process, the authors investigate job seekers’perceptions of importance of CSP and explore effects of CSP dimensions on organizational attractiveness. Job seekers consider CSP important to assessment of firms and rate five specific CSP dimensions (environment, community relations, employee relations, diversity, and product issues) as more important than six other CSP dimensions. Using signaling theory and social identity theory, the authors hypothesize differences in effects of (...) CSP data on ratings of employer attractiveness and find that environment, community relations, and diversity dimensions have the largest affect on attractiveness ratings. (shrink)

With calls for (business) leaders to contribute to greater global fairness and social justice (BAWB 2006; Maak and Pless Journal of Business Ethics, 88, 537–550, 2009), this paper considers gender equality on University home web page images as one means of communicating equal access to leadership roles for both men and women. Although there are many paths for leadership development, one important purpose of Universities is to create people who will potentially become leaders in our society (Shapiro 2005). We analyzed (...) the home web pages at 24 leading universities to identify implicit messages about gender roles, building on implicit leadership theory and leadership prototypes. Using an adapted version of Goffman’s frame analysis (1979), our results suggest depiction of gender equality in university home web pages, in contrast to studies of print advertisements (cf., Kang Sex Roles, 37(11/12), 979–996, 1997; Lindner Sex Roles, 51(7/8), 409–421, 2004). Our results also identify specific opportunities to depict greater equity and to continue to expand the potential for both women and men to be seen as being capable and belonging on this leadership path. (shrink)

Women used to be relegated to the periphery in psychology: most of us were not really heard as primary members of our discipline. Moreover, fundamental concepts and methods were developed by men about men, and applied to women only as an afterthought and without due process. Recently, more women are speaking straightforwardly from their experiences and are beginning to be heard with increasing respect, though change is slow. Concurrently, Women's Studies is coming to its own as an academic discipline. Now (...) it is paradoxical that as women psychologists, many of us find ourselves with one foot in each of two different worlds—one in psychology and the other in women's studies. As I reflect on what it must have been like for women many years ago in psychology and on how that experience has changed in my generation, I am coming to appreciate the intellectual challenge which I face. In this essay I discuss several epistemological and methodological issues in Women's Studies which are relevant to psychology in an attempt to bring both of my feet closer together. 2012 APA, all rights reserved). (shrink)

Obstructive sleep apnea (OSA) severely impacts sleep and has long-term health consequences. Treating sleep apnea with continuous positive airway pressure (CPAP) not only relieves obstructed breathing, but also improves sleep. CPAP improves sleep by reducing apnea-induced awakenings. CPAP may also improve sleep by enhancing features of sleep architecture assessed with electroencephalography (EEG) that maximize sleep depth and neuronal homeostasis, such as the slow oscillation and spindle EEG activity, and by reducing neurophysiological arousal during sleep (i.e., beta EEG activity). We examined (...) cross-sectional differences in quantitative EEG characteristics of sleep, assessed with power spectral analysis, in 29 adults with type 2 diabetes treated with CPAP and 24 adults undergoing SHAM CPAP treatment (total n = 53). We then examined changes in spectral characteristics of sleep as the SHAM group crossed over to active CPAP treatment (n = 19). Polysomnography (PSG) from the CPAP titration night was used for the current analyses. Analyses focused on EEG frequencies associated with sleep maintenance and arousal. These included the slow oscillation (0.5–1 Hz), sigma activity (12–16 Hz, spindle activity), and beta activity (16–20 Hz) in F3, F4, C3, and C4 EEG channels. Whole night non-rapid eye movement (NREM) sleep and the first period of NREM spectral activity were examined. Age and sex were included as covariates. There were no group differences between CPAP and SHAM in spectral characteristics of sleep architecture. However, SHAM cross-over to active CPAP was associated with an increase in relative 12–16 Hz sigma activity across the whole night and a decrease in average beta activity across the whole night. Relative slow oscillation power within the first NREM period decreased with CPAP, particularly for frontal channels. Sigma and beta activity effects did not differ by channel. These findings suggest that CPAP may preferentially enhance spindle activity and mitigate neurophysiological arousal. These findings inform the neurophysiological mechanisms of improved sleep with CPAP and the utility of quantitative EEG measures of sleep as a treatment probe of improvements in neurological and physical health with CPAP. (shrink)

Some theories suggest that women anticipate negative consequences (i.e., backlash) for counter-stereotypical actions and take steps to avoid those consequences. We propose that women may expect gender-based backlash for voicing, or contributing ideas that challenge the status quo, and thus engage in more silence (withholding those contributions) than men. However, we also propose that women anticipate gender backlash, and hence engage in more silence, only when other group members’ behavior signals that deviating from prescribed gender norms is risky. In two (...) studies with over 3000 participants, we found that incivility increased women’s expectation that voicing would lead to gender backlash. In turn, women engaged in more silence than men in uncivil groups, but we found no gender difference in silence in civil groups. Our findings reveal that certain situations differentially alert people to interpersonal risks, thus influencing their decision to withhold contributions. (shrink)

Background: Clinical genomic implementation studies pose challenges for informed consent. Consent forms often include complex language and concepts, which can be a barrier to diverse enrollment, and these studies often blur traditional research-clinical boundaries. There is a move toward self-directed, web-based research enrollment, but more evidence is needed about how these enrollment approaches work in practice. In this study, we developed and evaluated a literacy-focused, web-based consent approach to support enrollment of diverse participants in an ongoing clinical genomic implementation study. (...) Methods: As part of the Cancer Health Assessments Reaching Many (CHARM) study, we developed a web-based consent approach that featured plain language, multimedia, and separate descriptions of clinical care and research activities. CHARM offered clinical exome sequencing to individuals at high risk of hereditary cancer. We interviewed CHARM participants about their reactions to the consent approach. We audio recorded, transcribed, and coded interviews using a deductively and inductively derived codebook. We reviewed coded excerpts as a team to identify overarching themes. Results: We conducted 32 interviews, including 12 (38%) in Spanish. Most (69%) enrolled without assistance from study staff, usually on a mobile phone. Those who completed enrollment in one day spent an average of 12 minutes on the consent portion. Interviewees found the information simple to read but comprehensive, were neutral to positive about the multimedia support, and identified increased access to testing in the study as the key difference from clinical care. Conclusions: This study showed that interviewees found our literacy-focused, web-based consent approach acceptable; did not distinguish the consent materials from other online study processes; and valued getting access to testing in the study. Overall, conducting empirical bioethics research in an ongoing clinical trial was useful to demonstrate the acceptability of our novel consent approach but posed practical challenges. (shrink)

Academic integrity establishes a code of ethics that transfers over into the job force and is a critical characteristic in scientists in the twenty-first century. A student’s perception of cheating is influenced by both internal and external factors that develop and change through time. For students, the COVID-19 pandemic shrank their academic and social environments onto a computer screen. We surveyed science students in the United States at the end of their first COVID-interrupted semester to understand how and why they (...) believed their peers were cheating more online during a pandemic. Almost 81% of students indicated that they believed cheating occurred more frequently online than in-person. When explaining why they believed this, students touched on proctoring, cheating influences, and extenuating circumstances due to COVID-19. When describing how they believed cheating occurred more frequently online, students touched on methods for cheating and surreptitious behavior. The student reasonings were associated with four theories that have been used to examine academic dishonesty. Our results can aid institutions in efforts to quell student concerns about their peers cheating during emergencies. Interestingly, most student beliefs were mapped to planned behavior theory while only a few students were mapped to neutralization theory, suggesting it was a novel modality of assessment rather than a pandemic that shaped student perceptions. (shrink)

I argue that having a theory of mind requires having at least implicit knowledge of the norms of the community, and that an implicit understanding of the normative is what drives the development of a theory of mind. This conclusion is defended by two arguments. First I argue that a theory of mind likely did not develop in order to predict behavior, because before individuals can use propositional attitudes to predict behavior, they have to be able to use them in (...) explanations of behavior. Rather, I suggest that the need to explain behavior in terms of reasons is the primary function of a theory of mind. I further argue that in order to be motivated to offer explanations of behavior, one must have at least an implicit understanding of appropriate behavior, which implies at least an implicit understanding of norms. The second argument looks at three cases of nonhuman animal societies that appear to operate within a system of norms. While there is no evidence that any species other than humans have a theory of mind, there is evidence that other species have sensitivity to the normative. Finally, I propose an explanation for the priority of norms over a theory of mind: given an understanding of norms in a society, and the ability to recognize and sanction violations, there developed a need to understand actions that violated the norms, and such explanations could only be given in terms of a person's reasons. There is a significant benefit to being able to explain behavior that violates norms, because explanations of the right sort can also serve to justify behavior. (shrink)

The ethical principle of ‘respect for persons’ in clinical research has traditionally focused on protecting individuals’ autonomy rights, but respect for participants also includes broader, although less well understood, ethical obligations to regard individuals’ rights, needs, interests and feelings. However, there is little empirical evidence about how to effectively convey respect to potential and current participants. To fill this gap, we conducted exploratory, qualitative interviews with participants in a clinical genomics implementation study. We interviewed 40 participants in English or Spanish (...) about their experiences with respect in the study and perceptions of how researchers in a hypothetical observational study could convey respect or a lack thereof. Most interviewees were female, identified as Hispanic/Latino or non-Hispanic white, reported annual household income under US$60 000 and did not have a Bachelor’s degree ; 30% had limited health literacy. We identified four key domains for demonstrating respect: personal study team interactions, with an emphasis on empathy, appreciation and non-judgment; study communication processes, including following up and sharing results with participants; inclusion, particularly ensuring materials are understandable and procedures are accessible; and consent and authorisation, including providing a neutral informed consent and keeping promises regarding privacy protections. While the experience of respect is inherently subjective, these findings highlight four key domains that may meaningfully demonstrate respect to potential and current research participants. Further empirical and normative work is needed to substantiate these domains and evaluate how best to incorporate them into the practice of research. (shrink)

In previous decades, numerous involvements of adolescents in deviant behavior have been increasing, and previous researchers examined different variables that may influence these phenomena. This study was designed to look for the possible predictors of deviant behavior, as well as its association with family satisfaction and personality traits. The study was conducted on 1500 participants ages 12–19 years old from selected schools in Nueva Ecija. The researchers used the Deviant Behavior Variety Scale by Sanches et al.. It consists of 19 (...) items of a variety of deviant action such as thefts, drug and alcohol consumption, verbal and physical aggression, possession of weapons, vandalism, truancy, lies and defiance of authority, and selling drugs among adolescents. Out of 1500 samples, 1227 met the criteria for the deviant behavior scale. Descriptive and Inferential statistics such as Mean, sd, frequency, percentage, Regression analysis, Pearson-correlation, and Mann Whitney U test were used to analyze this study. The research found that there are differences in levels of deviant behavior among sexes. Results showed that female participants have higher tendency to engage in minor infractions of deviant acts, while males had a higher rate of participation in severe infractions of deviant acts. Moreover, there is a negative/inverse association between family satisfaction and deviant behavior. This implies that respondents who participate more in deviant behaviors are found to be less satisfied with their family life, while respondents who participate less in deviant behavior are more satisfied in their family life. Lastly, the current study found that personality trait-agreeableness is found to be the best predictor of deviant behavior among adolescents. (shrink)

This essay considers Pamela Sue Anderson’s work in relation to her participation in the Enhancing Life Project from 2015 until her death in 2017. Offering a critical interpretation and reconstruction of Anderson’s final work, this essay also gestures beyond it. It begins by narrating her participation in the Enhancing Life Project. Next, it focuses on her treatment of capability and vulnerability, identifying shifts in her thought and bringing theological symbols and a constructive theological interest to the conversation. Anderson depicted the (...) relation of capability and vulnerability as a “threshold for enhancing human life.” This contribution examines her implied metaphor of a spatial or temporal crossing point and evaluates Anderson’s original post-Kantian conceptualization of threshold in relation to the shifts in her thinking. A sympathetic but more adequate approach to enhancing vulnerable life can be informed by Simone de Beauvoir’s phenomenological approach to lived experience and her construal of the body as a lived situation. When vulnerability is interpreted as a situated susceptibility to being changed, for good or for ill, then threshold language can be reintroduced in relation to the intensification, enhancement, and transformation of life, that is, of the “aliveness of life.”. (shrink)

The chapter begins with a discussion of the determinism relatum (§2) and the free-will relatum (§3). The next section (§4) identifies four relations which are commonly used to characterize (in)compatibilism: metaphysical incompossibility, logical inconsistency, metaphysical incompatibility, and logical incompatibility. In closing (§5), I suggest a way to disambiguate the terms “compatibilism” and “incompatibilism”. -/- For the most recent draft, please gmail me: kristin.mickelson.42.

Voluntary actions and their distal effects are intimately related in conscious awareness. When an expected effect follows a voluntary action, the experience of the interval between these events is compressed in time, a phenomenon known as ‘intentional binding’ . Current accounts of IB suggest that it serves to reinforce associations between our goals and our intention to attain these goals via action, and that IB only occurs for self-generated actions. We used a novel approach to study IB in the context (...) of shared intentions and actions. Pairs of participants judged the time of occurrence of actions and events attributed either to oneself or to another agent. We found that IB and subjective agency are not mutually predictive when an action can be attributed to only one of two ‘co-intending’ agents. Our results pose a complication for the prevailing view that IB and subjective agency reflect a common mechanism. (shrink)

Purpose The purpose of this paper is to demonstrate privacy concerns arising from the rapidly increasing advancements and use of artificial intelligence technology and the challenges of existing privacy regimes to ensure the on-going protection of an individual’s sensitive private information. The authors illustrate this through a case study of energy smart meters and suggest a novel combination of four solutions to strengthen privacy protection. Design/methodology/approach The authors illustrate how, through smart meter obtained energy data, home energy providers can use (...) AI to reveal private consumer information such as households’ electrical appliances, their time and frequency of usage, including number and model of appliance. The authors show how this data can further be combined with other data to infer sensitive personal information such as lifestyle and household income due to advances in AI technologies. Findings The authors highlight data protection and privacy concerns which are not immediately obvious to consumers due to the capabilities of advanced AI technology and its ability to extract sensitive personal information when applied to large overlapping granular data sets. Social implications The authors question the adequacy of existing privacy legislation to protect sensitive inferred consumer data from AI-driven technology. To address this, the authors suggest alternative solutions. Originality/value The original value of this paper is that it illustrates new privacy issues brought about by advances in AI, failings in current privacy legislation and implementation and opens the dialog between stakeholders to protect vulnerable consumers. (shrink)

The article examines how some culturally shared and corporeally enacted beliefs and norms about sexed and racialized embodiment can form embodied agency, and this with the aid of the concepts of incorporation and excorporation. It discusses how the phenomenological concept of excorporation can help us examine painful experiences of how one's lived body breaks in the encounter with others. The article also examines how a continuous excorporation can result in bodily alienation, and what embodied resistance can mean when one has (...) undergone or undergoes excorporation. Elaborating on the work of, among others, Maurice Merleau-Ponty, Martin Heidegger, Drew Leder, and Sarah Ahmed, I discuss incorporation and excorporation of beliefs and norms regarding sexual difference, such as beliefs and norms regarding female and male embodiment, through a reading of Jeffrey Eugenides' novel Middlesex. I also suggest that it is useful to understand the postcolonial scholar Frantz Fanon's narrative of how he could not but attend to his own skin color while living in France in the 1940s and 1950s, in terms of excorporation. Whereas these are different narratives in many ways, I regard them as helpful for clarifying what excorporation implies and what analytic work this concept can enable. (shrink)

Professional attire has traditionally been regarded as a sign of ethicality. However, recent trends towards a more casual workplace may have altered the general public’s attire-based perceptions. To determine whether these trends have rendered the association between professional attire and ethicality obsolete, we draw on signaling theory and we examine, in two laboratory studies with working samples, the main effects of attire style (i.e., business formal, business casual, casual) on perceptions of employee ethicality. We also assess the mediating effects of (...) attire appropriateness, the moderating effects of context (industry type), as well as their combined moderated-mediation effects in the relation between attire style and the outcome of interest. We find that casual attire is perceived as less ethical than business casual attire in both studies but is perceived as less ethical than business formal attire in the first study only. Moreover, the effect of attire style on perceptions of ethicality is mediated by perceptions of attire appropriateness. Lastly, we found inconclusive results for the moderated-mediation model, which suggest a more intricate effect of industry type than originally proposed. Three subsequent focus groups with working professionals provided additional insights into our findings and revealed workplace-relevant outcomes associated with perceptions of ethicality. Theoretical and practical implications, study limitations, and future research avenues are discussed. (shrink)

This paper expresses wonder about how bodies in motion can lead towards an understanding of lived meaning in silent lifeworlds. In such lifeworlds, expressions are without words, pre-symbolic, and thus embodied. To address the wonder, phenomenological philosophy and phenomenological methodology were employed to frame an approach that acknowledges lives with disabilities as qualitatively different from, and yet not inferior to, nor less imbued with meaning than, lives without.The paper focuses on spatiality as decisive in determining possibilities for persons to express (...) their perspectives through a wide range of movements. Movements take place in the continuum between the spatiality of positions as objective bodily sensations and the spatiality of situations as embodied interactions with others and the world. Thus, in order to access the perspectives of students with severe and multiple disabilities, transitions between and movements within different spaces are examined.Approaching an educational everyday life where students are restricted in the possibilities available to them for moving in and out of spaces, the study reported points to the importance of recognizing the relationship between subjective movements and the spaces enveloping them as what creates a spatiality that is meaningful to the subject. It is accordingly suggested that choosing which spaces to include in educational contexts are formative choices that express a view of humanity. The paper also emphasizes the importance of recognizing temporality as a pedagogical resource when detecting and acting upon students’ changing expressions. (shrink)

Abstract The rapidly growing presence of private military and security contractors (PMSCs) in armed conflict and post-conflict situations in the last decade brought corresponding incidents of serious misconduct by PMSC personnel. The two most infamous events?one involving the firm formerly known as Blackwater and the other involving Titan and CACI?engendered scrutiny of available mechanisms for criminal and civil accountability of the individuals whose misconduct caused the harm. Along a parallel track, scholars and policymakers began examining the responsibility of states and (...) international organizations for the harm that occurred. Both approaches have primarily focused on post-conduct accountability?of the individuals who caused the harm, of the state in which the harm occurred, or of the state or organization that hired the PMSC whose personnel caused the harm. Less attention, however, has been paid to the idea of pre-conduct accountability for PMSCs and their personnel. A broad understanding of ?accountability for? PMSCs and their personnel encompasses not only responsibility for harm caused by conduct, but responsibility for hiring, hosting, and monitoring these entities, as well as responsibility to the victims of the harm. This article provides a comprehensive approach for analyzing the existing international legal regime, and whether and to what extent the legal regime provides ?accountability for? PMSCs and their personnel. It does so by proposing a practical construct of three phases based on PMSC operations?Contracting, In-the-Field, and Post-Conduct?with which to assess the various bodies of international law. (shrink)

The influence of pervasive cultural norms on people’s actions constitutes a longstanding problem for autonomy theory. On the one hand, such norms often seem to elude the kind of reflection that autonomous agency requires. On the other hand, they are hardly entirely beyond the pale of autonomy: people do sometimes reflect critically on them and resist them. This paper draws on phenomenological accounts of embodiment in order to reconcile these observations. We suggest that pervasive cultural norms exert a strong and (...) elusive, but occasionally resistible, influence because they are incorporated – they operate on the largely pre-reflective bodily level of human existence. As an illustration we discuss parental decisions about surgery for children born with unclear sex, decisions permeated by deeply entrenched norms about sexual difference and genital appearance. (shrink)

I suggest a pluralistic account of folk psychology according to which not all predictions or explanations rely on the attribution of mental states, and not all intentional actions are explained by mental states. This view of folk psychology is supported by research in developmental and social psychology. It is well known that people use personality traits to predict behavior. I argue that trait attribution is not shorthand for mental state attributions, since traits are not identical to beliefs or desires, and (...) an understanding of belief or desire is not necessary for using trait attributions. In addition, we sometimes predict and explain behavior through appeal to personality traits that the target wouldn't endorse, and so could not serve as the target's reasons. I conclude by suggesting that our folk psychology includes the notion that some behavior is explained by personality traits—who the person is—rather than by beliefs and desires—what the person thinks. Consequences of this view for the debate between simulation theory and theory theory, as well as the debate on chimpanzee theory of mind are discussed. (shrink)

Enhancement of autonomous choice may be considered as an important reason for facilitating the use of genetic tests such as preimplantation genetic diagnosis. The principle of respect for autonomy is a crucial component not only of Western liberal traditions but also of Western bioethics. This is especially so in bioethical discussions and analyses of clinical encounters within medicine. On the basis of an analysis of qualitative research interviews performed with British, Italian and Swedish geneticists and gynaecologists on ethical aspects of (...) preimplantation genetic diagnosis, the plausibility of the notion of autonomy within reproductive medicine is discussed. The analysis of interviews indicates not only that there is a gap between theoretical discussions and concrete practice, but also that an increase in choice — paradoxically — can hamper couples' choice. (shrink)

Volume 20, Issue 7, July 2020, Page 207-209.

Andrews argues for a pluralistic folk psychology that employs different kinds of practices and different kinds of cognitive tools (including personality trait attribution, stereotype activation, inductive reasoning about past behavior, and ...

Some bioethicists engage with empirical work on stakeholders’ values, attitudes, and experiences as a basis for theorizing ethics in the context of healthcare. Related to this empirical turn, a deb...

Introduction Deep brain stimulation (DBS) is approved under a humanitarian device exemption to manage treatment-resistant obsessive-compulsive disorder (TR-OCD) in adults. It is possible that DBS may be trialed or used clinically off-label in children and adolescents with TR-OCD in the future. DBS is already used to manage treatment-resistant childhood dystonia. Evidence suggests it is a safe and effective intervention for certain types of dystonia. Important questions remain unanswered about the use of DBS in children and adolescents with TR-OCD, including whether (...) mental health clinicians would refer pediatric patients for DBS, and who would be a good candidate for DBS.Objectives To explore mental health clinicians’ views on what clinical and psychosocial factors they would consider when determining which children with OCD would be good DBS candidates.Materials and Methods In depth, semi-structured interviews were conducted with n = 25 mental health clinicians who treat pediatric patients with OCD. The interviews were transcribed, coded, and analyzed using thematic content analysis. Three questions focused on key, clinical, and psychosocial factors for assessing candidacy were analyzed to explore respondent views on candidacy factors. Our analysis details nine overarching themes expressed by clinicians, namely the patient’s previous OCD treatment, OCD severity, motivation to commit to treatment, presence of comorbid conditions, family environment, education on DBS, quality of life, accessibility to treatment, and patient age and maturity.Conclusions Clinicians generally saw considering DBS treatment in youth as a last resort and only for very specific cases. DBS referral was predominantly viewed as acceptable for children with severe TR-OCD who have undertaken intensive, appropriate treatment without success, whose OCD has significantly reduced their quality of life, and who exhibit strong motivation to continue treatment given the right environment. Appropriate safeguards, eligibility criteria, and procedures should be discussed and identified before DBS for childhood TR-OCD becomes practice. (shrink)

The growing literature on gender in armed conflict and the debates over post-conflict reparations for women, focus on the prevalence and harms of sexual violence. While this focus has recently been critiqued, there are few articulations of other types of gendered injuries. This article decentres the emphasis on sexual violence by examining the intersection between forced displacement and political insecurity. Based on extensive field research in Colombia, and using as an example a case study of an internally displaced women’s grassroots (...) organization in Cartagena, Colombia, this article examines political insecurity as a specifically gendered harm. It reflects on the concrete circumstances of insecurity, on the relevance of traditional gender roles in the constitution of insecurity, and on the challenges for court-ordered remedies. This widening of the scope of attention also invites complex reflection on the possibility of transformative reparations in post-conflict situations. (shrink)

This study examined the direct influence of national economic condition, as well as the indirect effects through the strength of noneconomic institutions on supervisors’ ethical reasoning using the institutional anomie theory developed by Messner and Rosenfeld :1393–1416, 2001). Utilizing data of 20,025 supervisors across 52 countries, the analyses showed that high disparity in the economic distribution directly and indirectly leads to unethical values. High economic inequality in a country resulted in high tendency of supervisors to justify unethical acts. In addition, (...) some of this influence went through the institutional strength of family, education, polity, and religion, thereby indicating partial mediation. As a result, the study presented the important roles of social institutions in explaining supervisors’ attitude and behavior. The findings of this research contribute to the institutional anomie theory by clarifying the multilevel path of the macrostructures’ conditions in explaining supervisors’ ethicality. Moreover, since some of the relationships between variables resulted in the direction opposite to the propositions of the theory, this study suggested other theoretical models that may be integrated with IAT. Along with these theoretical contributions, practical implications to businesses and society are discussed to strengthen supervisors’ ethics. (shrink)

This paper introduces the theme of killing‐them‐softly between set‐theoretic universes. The main theorems show how to force to reduce the large cardinal strength of a cardinal to a specified desired degree. The killing‐them‐softly theme is about both forcing and the gradations in large cardinal strength. Thus, I also develop meta‐ordinal extensions of the hyper‐inaccessible and hyper‐Mahlo degrees. This paper extends the work of Mahlo to create new large cardinals and also follows the larger theme of exploring interactions between large cardinals (...) and forcing central to modern set theory. (shrink)

Since John Locke, regnant conceptions of personhood in Western philosophy have focused on individual capabilities for complex forms of consciousness that involve cognition such as the capability to remember past events and one’s own past actions, to think about and identify oneself as oneself, and/or to reason. Conceptions of personhood such as Locke's qualify as cognition-oriented, and they often fail to acknowledge the role of embodiment for personhood. This article offers an alternative conception of personhood from within the tradition of (...) phenomenology of the body. The article presents a phenomenological analysis of joint musical activity in dementia care and outlines an intercorporeal conception of personhood based on this analysis. It also provides a philosophical basis for the idea that others can hold us in personhood, and it questions a strict one-body-one-person logic that has pertained in much personhood debate. (shrink)