The contribution of this work is a classification of corporate social action underlying the Social Ratings Data compiled by Kinder Lydenburg Domini Analytics, Inc. We compare extant typologies of corporate social action to the results of our exploratory factor analysis. Our findings indicate four distinct latent constructs that bear resemblance to concepts discussed in prior literature. Akey finding of our research is that positive and negative social action are both empirically and conceptually distinct constructs and should not be combined in (...) future research. Additionally, we recommend that some prior research results be reconsidered to determine whether these newly derived measures might clarify some previous findings. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

If dominating functions in ω ω are adjoined repeatedly over a model of GCH via a finite-support c.c.c. iteration, then in the resulting generic extension there are no long towers, every well-ordered unbounded family of increasing functions is a scale, and the splitting number s (and hence the distributivity number h) remains at ω 1.

Moral distress is a major problem for nurses, other clinicians, and the health system itself. But if properly understood and responded to, it is also a promising guide for healthcare improvement. When individuals experience moral distress or burnout, their reports must be seen as crucial data requiring careful attention to the individuals and to the organization. Distress and burnout will often point to important opportunities for system improvements, which may in turn reduce the experience of distress. For this potential virtuous (...) cycle to happen, individuals must be able to articulate their concerns without fear of retribution, and organizational leaders must be able to listen in an undefensive, improvementoriented manner. (shrink)

Let κ denote a regular uncountable cardinal and NS the normal ideal of nonstationary subsets of κ. Our results concern the well-known open question whether NS fails to be κ + -saturated, i.e., are there κ + stationary subsets of κ with pairwise intersections nonstationary? Our first observation is: Theorem. NS is κ + -saturated iff for every normal ideal J on κ there is a stationary set $A \subseteq \kappa$ such that $J = NS \mid A = \{X \subseteq (...) \kappa:X \cap A \in NS\}$ . Turning our attention to large cardinals, we extend the usual (weak) Mahlo hierarchy to define "greatly Mahlo" cardinals and obtain the following: Theorem. If κ is greatly Mahlo then NS is not κ + -saturated. Theorem. If κ is ordinal Π 1 1 -indescribable (e.g., weakly compact), ethereal (e.g., subtle), or carries a κ-saturated ideal, then κ is greatly Mahlo. Moreover, there is a stationary set of greatly Mahlo cardinals below any ordinal Π 1 1 -indescribable cardinal. These methods apply to other normal ideals as well; e.g., the subtle ideal on an ineffable cardinal κ is not κ + -saturated. (shrink)

While the prevalence of opioid use disorder among pregnant women has multiplied in the United States in the last decade, buprenorphine treatment for peripartum women with OUD has been administered to reduce risks of repeated cycles of craving and withdrawal. However, the maternal behavior and bonding in mothers with OUD may be altered as the underlying maternal behavior neurocircuit is opioid sensitive. In the regulation of rodent maternal behaviors such as licking and grooming, a series of opioid-sensitive brain regions are (...) functionally connected, including the ventral pallidum. In humans, these brain regions, interact with the supplementary motor area to regulate maternal behaviors and are functionally dysregulated by opioids. It is unclear how these brain regions respond to the emotions of their child for mothers receiving BT. In this functional magnetic resonance imaging pilot study in 22 mothers within the first postpartum year, including six mothers receiving BT and 16 non-OUD mothers as a comparison group, we devised a child face mirroring task in fMRI settings to assess maternal responses to pictures of facial expressions of own child and an unknown child in an empathic mirroring condition and a non-mirroring observation condition. In each condition, faces of neutral, ambiguous, distressed, and joyful expressions of each child were repeatedly displayed in a random order. The response of SMA during empathic mirroring vs. non-mirroring of own child was reduced among BT/OUD vs. CG. Within MBN, the left VP, critical for parental sensitivity, had a similar deficit. This study outlines potential mechanisms for investigating the risks of deficits in the neural responses to actual maternal sensitivity and parenting behavior in mothers with OUD, and potential targets for interventions that reduce stress and augment maternal behavior and child outcome. (shrink)

Although leaders in the field of ethics have for many years pointed to the crucial role that organizations play in shaping healthcare ethics, organizational ethics remains a relatively undeveloped area of ethics activity. Clinical ethics committees are an important source of potential expertise, but new skills will be required. Clinical ethics committees seeking to extend their purview to organizational issues will have to respond to three challenges—how to gain sanction and support for addressing controversial and sensitive issues, how to develop (...) an acceptable process, and how to make a difference on the ground. The article presents practical suggestions for how clinical ethics committees meet these challenges. (shrink)

This dissertation presents an objection to Wittgenstein's concept of family resemblances, three possible solutions to the objection, evaluations of the solutions, and a sketch of Wittgenstein's approach to the objection. My thesis is that none of the three proposed solutions is satisfactory, but that Wittgenstein can deal with the objection. ;Chapter I presents the Problem of the Under-Determination of Extension, the claim that family resemblances are not enough to explain the extension of a concept, since resemblances may be postulated between (...) cases falling under different concepts. ;Chapters II and III discuss three solutions proposed by commentators on family resemblances. The Basic Predicates Solution claims that points of family resemblance are sufficient conditions, and is incorrect since Wittgenstein denies that one can infer the applicability of a concept based on the presence of a resemblance to an instance of the concept. The Simple Properties Solution claims that only some concepts are family resemblance concepts, and depend upon concepts which are not family resemblance concepts, and is incorrect, since Wittgenstein does not require that family resemblance concepts be reducible to non-family resemblance concepts. The Bi-Directional Determination of Concepts Solution is the claim that a concept is determined by an interaction between facts about cases subsumed under it, and needs and purposes of language-users. This solution is non-Wittgensteinian by ignoring the ramifications of his concepts of grammar and language-games. ;Chapter IV argues that Wittgenstein deals with the original objection by developing new models for understanding language, involving the concepts of grammar and language-games. (shrink)

Current discussions of business ethics usually only consider deontological and utilitarian approaches. What is missing is a discussion of traditional teleology, often referred to as virtue ethics. While deontology and teleology are useful, they both suffer insufficiencies. Traditional teleology, while deontological in many respects, does not object to utilitarian style calculations as long as they are contained within a moral framework that is not utilitarian in its origin. It contains the best of both approaches and can be used to focus (...) on the individual''s role within an organization. More work is needed in exposing students and faculty to traditional teleology and its place in business ethic''s discussions. (shrink)

My criticisms of parapsychology are neither based on its subject matter per se, nor simply on a charge of sloppy research, but rather on the whole pattern of theory and research in this domain. The lack of a positive definition of psi, the use of ad hoc principles such as psi-missing and the experimenter psi effect to account for failures to confirm hypotheses, and the failure to produce a single phenomenon that can be replicated by neutral investigators are among the (...) major problems that keep parapsychology outside regular science. Glicksohn and I agree that anomalous experiences should be investigated. (shrink)

It is shown that if ZF is consistent, then so is ZFC + GCH + "There is a graph with cardinality ℵ 2 and chromatic number ℵ 2 such that every subgraph of cardinality ≤ ℵ 1 has chromatic number ≤ ℵ 0 ". This partially answers a question of Erdos and Hajnal.

In this article, I examine both the problem of so-called postmodern history as it relates to the Holocaust and suggest the ways that Saul Friedlander's recent work successfully mediates between the somewhat overly polemicized positions of "relativist" and "positivist" history. In this context, I find that in his search for an adequately self-reflexive historical narrative for the Holocaust, Hayden White's proposed notion of "middle-voicedness" may recommend itself more as a process for eyewitness writers than as a style for historians after (...) the fact. From here, I look at the ways Saul Friedlander's reflections on the historian's voice not only mediate between White's notions of the ironic mode and middle-voicedness, but also suggest the basis for an uncanny history in its own right: an anti-redemptory narrative that works through, yet never actually bridges, the gap between a survivor's "deep memory" and historical narrative.For finally, it may be the very idea of "deep memory" and its incompatibility to narrative that constitutes one of the central challenges to Holocaust historiography. What can be done with what Friedlander has termed "deep memory" of the survivor, that which remains essentially unrepresentable? Is it possible to write a history that includes some oblique reference to such deep memory, but which leaves it essentially intact, untouched and thereby deep? In this section, I suggest, after Patrick Hutton, that "What is at issue here is not how history can recover memory, but, rather, what memory will bequeath to history." That is, what shall we do with the living memory of survivors? How will it enter the historical record? Or to paraphrase Hutton again, "How will the past be remembered as it passes from living memory to history?" Will it always be regarded as so overly laden with pathos as to make it unreliable as documentary evidence? Or is there a place for the understanding of the witness, as subjective and skewed as it may be, for our larger historical understanding of events?In partial answer to these questions, I attempt to extend Friedlander's insights toward a narrow kind of history-telling I call "received history"-a double-stranded narrative that tells a survivor-historian's story and my own relationship to it. Such a narrative would chart not just the life of the survivor-historian itself but also the measurable effect of the tellings-both his telling and mine-on my own life's story. Together, they would compose a received history of the Holocaust and its afterlife in the author's mind-my "vicarious past.". (shrink)

Should mental health insurance cover only disorders found in DSM‐IV, or should it be extended to treatment for ordinary shyness, unhappiness, and other responses to life's hard knocks?