In this narrative essay, a happenstance encounter with a journal article rekindles the author’s intense memories of a cardiac resuscitation 25 years earlier during internship. Recollections of observations, emotions, and professional interactions around this event prompt reflection about the painful experiences from training that remain seared into memory and the value of these formative moments across a professional lifetime.

Background and Objectives Primary care providers (PCPs) report decreased job satisfaction and high levels of burnout, yet little is known about their experience of moral distress. The aim of this study was to gain insight into the experiences of PCPs regarding moral distress including causative factors and proposed mitigation strategies. Methods This qualitative pilot study used semi-structured interviews to identify causes of moral distress in PCPs in an academic family medicine department. Interviews were analyzed using conventional content analysis. Results Of (...) 35 eligible participants, 12 completed the study (34% participation rate). Most were white, female, and had practiced for less than 10 years. Four PCPs had considered leaving their position due to moral distress. Participants identified five causes of moral distress: policies and procedures that conflict with patient needs, the unpredictable nature of primary care, need to “bend the rules,” lack of accountability, and lack of support staff. Six internal conflicts made resolving morally distressing situations difficult: perceived powerlessness, sense of responsibility, socialization to follow orders, emotional toll of the job, competing obligations, and fear of mistakes. Conclusions These findings matched themes in the current literature and identified an unbending infrastructure. This, coupled with the chaotic nature of primary care, resulted in frequent moral distress. Participants offered solutions to reduce and mitigate moral distress (also similar with current literature) and suggested moral distress and burnout are closely linked. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Tolle, LegeCommencement Address at the Dominican House of Studies, May 13, 2022Michael RootTolle, lege. Tolle, lege. "Take up, read." Few such simple words have had such a crucial impact on the history of Christian theology. In the summer of 386, Augustine of Hippo was a torn man. He had come to believe the Gospel, but he could not bring himself to break with sinful habits, habits so ingrained he (...) called them "necessities." His soul was torn between two wills within him, he said, each pointing in a different direction. Nothing seemed able to be able to break the interior logjam. He says that he willed that he would will the good, but not with a complete will, and so he remained paralyzed. After hearing a friend and mentor describe the conversion of Victorinus, a famous Roman teacher of rhetoric, and another friend speak of the monastic retreat of St. Anthony, the spiritual conflict within Augustine reached a fever pitch and he retreated to a corner of the garden in the house he was staying at. Suddenly, from over the wall, he heard a child chanting the words tolle, lege: "take up, read." He could not think of any childhood rhyme or chant that involved those words—they must be a sign from God. So, he rushed over to where a copy of St. Paul's letters was lying, opened it, and read at random. His eye fell on Romans 13:13: "Let us conduct ourselves becomingly as in the day, not in reveling and drunkenness, not in debauchery and licentiousness, not in quarreling and jealousy." As he himself puts in his Confessions: "No further wished I to read, nor was there need to do so. Instantly, in truth, at the end of this sentence, as if before a peaceful light streaming into my heart, all the dark shadows of doubt fled away" (8.12.29). [End Page 9]You who are graduating are now coming to the end of a process that has involved a great deal of taking up and reading. I trust that the taking up and reading has not been to cure you of reveling and drunkenness, not to mention the rest of St. Paul's list, but rather to form you, most immediately within the discipline of theology and for many of you, within the vocation of the priesthood and the Dominican Order. Some of what you have taken up and read has, I hope, been inspiring. I hope that at least on occasion you felt as if a peaceful light was streaming into your hearts. Some of what you read, I would guess, you found mind-numbingly boring. But it is all part of the process.Of course you did more than just take up and read. You thought about what you were reading. You compared it with other things you had read. You related it to your own experience. You discussed it with other students. You wrote about it in papers and on exams. The medieval university master had three tasks: legere, disputare, praedicare—read, dispute, and (in this context) present. You have done much the same thing—reading, arguing, presenting.Reading with this kind of attention does not leave us unaffected. We do not just learn new information; we come to inhabit a different world, with a different landscape and a different population. It makes a difference whether one's effective world includes only places like Washington, New York, and Elizabeth, New Jersey, or also Jerusalem, the old Jerusalem and the new Jerusalem, the North Africa of Augustine, and the Paris of Thomas Aquinas. The person whose imaginative world is mostly populated by characters from Friends and Game of Thrones will be a different sort of person from the one whose imaginative world includes Abraham, David, St. Paul, Dominic, and Alyosha Karamazov. It is as much an exaggeration to say you are what you read as to say you are what you eat. But at least for some of us (and if you are graduating from Pontifical Faculty of the Immaculate Conception, you are probably in this group), at least some of what we read changes not only what we... (shrink)

In arguing about justice, different sides often accept common moral principles, but reach different conclusions about justice because they disagree about facts. I argue that motivated reasoning, epistemic injustice, and ideologies of injustice support unjust institutions by entrenching distorted representations of the world. Working from a naturalistic conception of justice as a kind of social contract, I suggest some strategies for discovering what justice demands by counteracting these biases. Moral sentiments offer vital resources to this end.

What is the proper role of politics in higher education? Many policies and reforms in the academy, from affirmative action and a multicultural curriculum to racial and sexual harassment codes and movements to change pedagogical styles, seek justice for oppressed groups in society. They understand justice to require a comprehensive equality of membership: individuals belonging to different groups should have equal access to educational opportunities; their interests and cultures should be taken equally seriously as worthy subjects of study, their persons (...) treated with equal respect and concern in communicative interaction. Conservative critics of these egalitarian movements represent them as dangerous political meddling into the disinterested pursuit of knowledge. They cast the pursuit of equality as a threat to freedom of speech and academic standards. In response, some radical advocates of such programs agree that the quest for equality clashes with free speech, but view this as an argument for sacrificing freedom of speech. (shrink)

This is not a transcription. More like a reenactment of the possibilities of performative poetics as improvisatory, open-ended.As a way to engage the relation of poetics to poetry and by implication differentiate poetics from literary theory and philosophy, although not necessarily from poetry.As a way to extend the ideas about closure—the rejection of closure—into the discussion of essays and critical writing.To eject, that is, the idea that there is something containable to say: completed saying.So that poetics becomes an activity that (...) is ongoing, that moves in different directions at the same time, and that tries to disrupt or make problematic any formulation that seems too final or preemptively restrictive.Speaking at the Buffalo conference, Linda Reinfeld pointed to the wedding that was being enacted between critical theory and poetry as a kind of subtext of that gathering. Hearing Rosmarie Waldrop read, in that context, from Reproduction of Profiles suggested something very much along these lines: Waldrop has created a literary wedding, in the sense of wedding together, or fusing, of philosophy and poetry. In this work, she has taken phrases from Elizabeth Anscombe’s translation of Ludwig Wittgenstein’s Philosophical Investigations and added—weaved in—phrases of her own making. The structure of Reproduction of Profiles provokes a number of questions, including the status of Wittgenstein’s original text, which may itself be taken as a poetic work, and also the status of the Reproduction of Profiles—what kind of a work is that? Charles Bernstein is the author of a number of books of poetry, including Rough Trades, The Nude Formalism, The Lives of the Toll Takers, The Sophist, and Controlling Interests. Other books include Content’s Dream: Essays 1975-1984 and Artifice of Absorption. He coedited L=A=N=G=U=A=G=E and recently edited The Politics of Poetic Form: Poetry and Public Policy. (shrink)

First published in 1998. Routledge is an imprint of Taylor & Francis, an informa company.

A series of experiments investigated the effect of speakers’ language, accent, and race on children’s social preferences. When presented with photographs and voice recordings of novel children, 5-year-old children chose to be friends with native speakers of their native language rather than foreign-language or foreign-accented speakers. These preferences were not exclusively due to the intelligibility of the speech, as children found the accented speech to be comprehensible, and did not make social distinctions between foreign-accented and foreign-language speakers. Finally, children chose (...) same-race children as friends when the target children were silent, but they chose other-race children with a native accent when accent was pitted against race. A control experiment provided evidence that children’s privileging of accent over race was not due to the relative familiarity of each dimension. The results, discussed in an evolutionary framework, suggest that children preferentially evaluate others along dimensions that distinguished social groups in prehistoric human societies. (shrink)

Le 11 mai 1793, Sir Gilbert Elliot écrit une lettre à sa femme dans laquelle il s’étonne d’une nouvelle mode qu’il a observée au bal offert par une amie. Lady Abercorn organise une soirée dansante « où se trouve une douzaine de femmes vêtues en statues, c’est-à-dire, avec la gaine placée juste en dessous des seins et une draperie de tissu qui tombe ». Sir Elliot précise que ces femmes « n’étaient pas tout à fait dénudées, mais l’effet était néanmoins (...) celui de la nudité ». Il témoigne que son... (shrink)

Amartya Sen’s ethical theorizing helps feminists resolve the tensions between the claims of women’s particular perspectives and moral objectivity. His concept of ‘‘positional objectivity’’ highlights the epistemological significance of value judgments made from particular social positions, while holding that certain values may become widely shared. He shows how acknowledging positionality is consistent with affirming the universal value of democracy. This article builds on Sen’s work by proposing an analysis of democracy as a set of institutions that aims to intelligently utilize (...) positional information for shared ends. This epistemological analysis of democracy offers a way to understand the rationale for reserving political offices for women. From a political point of view, gendered positions are better thought of as an epistemological resource than as a ground of identity politics – that is, of parochial identification and solidarity. (shrink)

When a cell divides, it produces two daughter cells initially connected by a cytokinesis bridge, which is eventually cut through abscission. One of the two daughter cells inherits a bridge “remnant”, which has been proposed to be degraded by autophagy. The fate and function of remnants is attracting increasing attention, as their accumulation appears to influence proliferation versus differentiation of the daughter cells. Here, we present a simple model for bridge and remnant turnover in a dynamic cell population. We demonstrate (...) that remnant proportions depend on the ratio of remnant and bridge lifetimes to the cell population doubling time. Our results yield new alternative interpretations for published experimental data, leading us to believe that autophagy‐independent pathways for remnant degradation may exist. In addition, using the model, we determined experimentally inaccessible parameters such as remnant lifetime. Our model proves to be a useful tool for studying bridge and remnant populations. (shrink)

ABSTRACT This essay meditates on the entanglement of history and memory with forgetfulness, with silencing, with what is before or outside speech. Recalling along the way a few of the manifold varieties of the unthinkable made manifest in recent events, it notes the same mute iteration that led Freud to the death drive, only to be troubled once again by the very same repetitions enfolded in the diagnosis of cultural malaise Freud built upon his insight. Turning to Georg Simmel’s Philosophy (...) of Money for an alternative, non-psychoanalytic account of unconscious purpose as a trans-individual, cultural phenomenon, it arrives once again at the hypertrophic life-technologies of the modern—and at Simmel’s account of money as the ultimate being without qualities, “the most extreme … configuration of Geist” itself, which so thoroughly underpins ways of living that, obscuring dimensions of value that cannot be quantified, silently hum on in the face of catastrophe. (shrink)

Most readers of Louis Althusser first enter his work through his writings on ideology. In an important new essay Étienne Balibar, friend and colleague of Althusser, offers an original reading of Althusser’s idea of ideology, drawing on both recently published posthumous writing and Althusser's work on the Piccolo Teatro di Milano. Balibar’s essay uncovers the intricate workings of interpellation through Althusser’s essays on the theater. If debates on dialectical materialism belong to a distant history, Balibar suggests, the question of ideology (...) remains crucial for thinking the present. The issue includes commentaries on Balibar’s essay from five influential scholars who engage critically with Althusser’s philosophy: Judith Butler, Banu Bargu, Adi Ophir, Warren Montag, and Bruce Robbins. This issue reanimates Althusser’s concept of ideology as an analytic tool for contemporary cultural and political critique. (shrink)

Sea of Troubles shows teachers how literature and informational texts can work together to enhance each other and, by extension, enhance students’ abilities to critically think and respond to the sea of troubles that pervades society.

_Global Discovery Activities_ is a ready-to-use guide that helps students learn and appreciate cultures from around the world. Each section explores a different culture and includes recommendations for children’s books, folk tales, celebrations, games, songs, arts and crafts, and foods. This informative and fun-filled book contains more than 400 activities and 150 full-page reproducible activity sheets. _Global Discovery_ will help your students learn about the cultures of * Africa * Asia * Australia and New Zealand * Canada * Caribbean and (...) other Islands * East Europe * Western Europe * Latin America * North America. (shrink)

ABSTRACT The author disagrees with Aaron Weinacht’s contention that Ayn Rand brought nihilism to America. Rand wrote about issues that concerned nihilist thinkers such as Nikolai Chernyshevskii, but she reacted in a profoundly different way to those issues. The differences are not merely political–insofar as the nihilists were socialist and Rand was a capitalist; they were much deeper.

Recently a number of authors have responded to the knowl-edge argument by suggesting that Mary could learn about new physi-cal facts upon release (Flanagan, 1992; Mandik, 2001; Stoljar, 2001; Van Gulick, 1985). A key step in achieving this is a demonstration that there are facts that can be known via colour experience that cannot be learnt scientifically. In this paper I develop an account of scientific and visual knowledge on which there is a difference between the knowledge provided by science (...) and that provided by vision. (shrink)

Normals display selective deficits in morphology and syntax under adverse processing conditions. Digit loads do not impair processing of passives and object relatives but do impair processing of grammatical morphemes. Perceptual degradation and temporal compression selectively impair several aspects of grammar, including passives and object relatives. Hence we replicate Caplan & Waters's specific findings but reach opposite conclusions, based on wider evidence.

Mature representations of number are built on a core system of numerical representation that connects to spatial representations in the form of a ‘mental number line’. The core number system is functional in early infancy, but little is known about the origins of the mapping of numbers onto space. Here we show that preverbal infants transfer the discrimination of an ordered series of numerosities to the discrimination of an ordered series of line lengths. Moreover, infants construct relationships between individual numbers (...) and line lengths that vary positively, but not between numbers and lengths that vary inversely. These findings provide evidence for an early developing predisposition to relate representations of numerical magnitude and spatial length. A central foundation of mathematics, science and technology therefore emerges prior to experience with language, symbol systems, or measurement devices. (shrink)

How does gender affect work rewards for professionals in a state-run economy? Using surveys from physicians in Estonia in 1991, the authors first found that the gender of the physician did not affect the level of formal rewards. However, because the state allocated formal rewards on the basis of professional purity, which was negatively correlated with feminization, specialties that had the greatest proportion of women also had the lowest formal rewards. These findings contrast with the author's findings for the level (...) of informal “black market” rewards. Women were less likely to receive informal rewards than men, especially if they worked in subfields high in professional purity. The authors conclude that the link between professional purity and feminization is critical in explaining pay differences informal work rewards while gender itself is the critical factor in explaining informal reward differences. (shrink)

This response draws on Saba Mahmood's work on Muslim subjectivities in order to consider how Stalnaker's conceptualization of virtue might be applied to non-Confucian sources. I argue that when applied cross-culturally, Stalnaker's revised definition of “skillful virtue” raises normative and metaethical questions about what counts as a skill versus a mere bodily practice, the process by how skill is acquired, and how we can both allow for the ambiguity of skills and continue to make constructive arguments about them.

Papers on nanotechnology in the Scientific Electronic Library Online database were studied bibliometrically. The terms ‘nanotechnology’, ‘nanoparticle’, ‘graphene’, ‘fullerene’, ‘nanotube’ and ‘quantum dot’ were used for the search in their singular and plural forms in three languages, and a total of 1205 papers were selected for the study to assess the frequency rates of the study variables. The results of the study are presented in this article focusing on gender differences.

Background: Caregivers and administrators in long-term facilities have fragile moral work in caring for residents with dementia. Residents are susceptible to barriers and vulnerabilities associated with the most intimate aspects of their lives, including how they express themselves sexually. The conditions for sexual agency are directly affected by caregivers’ perceptions and attitudes, as well as facility policies. Objective: This article aims to clarify how to approach capacity determinations as it relates to sexual activity, propose how to theorize about patient autonomy (...) in this context, and suggest some considerations for finding an ethically responsible and practically feasible way to respect the sexual rights of this population. Research Design: The focus is on residents with early to moderate dementia in states of daily dependency on professional caregivers. The article critically examines existing empirical research on sexuality among persons with dementia, caregivers’ attitudes, and institutional roadblocks to enabling residents’ sexuality. A relational lens and insights from disability studies are used in the philosophical analysis. Participants and Research Context: No research participants were part of this analysis. Ethical Considerations: This article offers a conceptual analysis and normative framework only. Findings: The analysis highlights the delicate balance that capacity assessments for sexual activity have to strike; while caregivers should protect those who cannot give adequate consent, the denial of sexuality among residents can cause deep, long-ranging harms. Sexual agency features into an ongoing sense of self for many individuals with dementia, and the imposition of inappropriate standards and expectations for sexual autonomy can lead to unwarranted obstacles to sexual activity. Discussion: Recommendations include developing clear and inclusive institutional policies and practices of care, providing education for caregivers on how to discuss and document residents’ sexual preferences over time, and taking advantage of ethics consultation services. Conclusion: This analysis establishes the need for more research and discussion on this sensitive topic. Future research should investigate the specific responsibilities of caregivers in furthering the sexual interests of residents, how exactly to modify existing capacity instruments, and how best to support historically marginalized patients in their sexual identities. (shrink)