IntroductionHead and neck cancer diagnosis and treatment can be a significant life trauma. Some HNC survivors experience post-traumatic growth, which has been linked with better health-related quality-of-life. Empirical research on PTG, and theoretical models, point to the importance of being able to purposely make sense of the traumatic experience. Intrusive rumination, by contrast, is linked to poorer outcomes. This study explored HNC survivors’ experiences of rumination.MethodsTwenty HNC survivors between 9 months and 5 years post-diagnosis were recruited. They had a range (...) of HNC sub-types and cancer treatments. Participants underwent a semi-structured interview about their cancer diagnosis and treatment. Reflexive thematic analysis identified themes and sub-themes around rumination.ResultsFour themes with linked subthemes on the content and process of rumination were identified. Theme 1 was rumination and worry related to diagnosis. Here, survivors discussed how the HNC diagnosis and plans for treatment had dominated their initial thoughts. Theme 2 was processing the trauma of HNC. This theme reflected rumination on the traumatic experience of diagnosis and treatment and how the participant was reacting to it. Theme 3 was considering the impact. This theme encompassed retrospective thinking and comparisons between the participant now versus the early days after diagnosis. Theme 4 was continued rumination. This theme included ongoing intrusive and distressing rumination about the trauma and impact of cancer. Those who expressed ongoing rumination revisited fears or returned to negative experiences.ConclusionThis study uniquely describes the nature and content of rumination following HNC. Early intrusive rumination is common and may reflect perceptions of cancer as an existential threat. Over time, rumination can become more reflective and move towards deliberate meaning-making. Some HNC survivors may benefit from interventions to reduce barriers to this transition. The content of distressing and difficult to control rumination helps to identify those who may benefit from more directed psychological support. (shrink)

Eating behaviors evolve during the first years of life as biological and behavioral processes directed towards meeting requirements for health and growth. For the vast majority of human history, food scarcity has constituted a major threat to survival, and human eating behavior and child feeding practices have evolved in response to this threat. Because infants are born into a wide variety of cultures and cuisines, they come equipped as young omnivores with a set of behavioral predispositions that allow them to (...) learn to accept the foods made available to them. During historical conditions of scarcity, family life and resources were devoted to the procurement and preparation of foods, which are often low in energy, nutrients, and palatability. In sharp contrast, today in non-Third World countries children's eating habits develop under unprecedented conditions of dietary abundance, where palatable, inexpensive, ready-to-eat foods are readily available. (shrink)

Catherine Malabou in The New Wounded develops a general theory of trauma by extending her account of destructive plasticity to the realm of post-traumatic stress disorder. “The new wounded,” she claims, “all come together around a single fact: the radical rupture that trauma introduces in the psyche”. This rupture is demonstrated by an affective fissure, which renders traumatized persons emotionally and socially mute, and a temporal fissure, which punctures subjects’ relationships to their pasts, thus tearing them from any sociohistorical context. (...) Malabou’s new wounded are marked by extreme indifference and a new, unrecognizable identity created ex nihilo with total absence at its center; at times she... (shrink)

Theory of mind competence and knowledge of emotions were studied longitudinally in a sample of preschoolers aged 3 (n=263) and 4 (n=244) years. Children were assessed using standard measures of theory of mind and emotion knowledge. Three competing hypotheses were tested regarding the developmental associations between children's theory of mind abilities and their knowledge of emotions. First, that an understanding of emotion develops early and informs children's understanding of others’ thinking. Alternatively, having a basic theory of mind may help children (...) learn about emotions. Third, that the two domains are separate aspects of children's social cognitive skills such that each area develops independently. Results of hierarchical regressions supported the first hypothesis that early emotion understanding predicts later theory-of-mind performance, and not the reverse. (shrink)

Lapses in ethical conduct by those in corporate and public authority worldwide have given business researchers and practitioners alike cause to re-examine the antecedents to personal ethical values. We explore the relationship between ethical values and an individual’s long-term orientation or LTO, defined as the degree to which one plans for and considers the future, as well as values traditions of the past. Our study also examines the role of work ethic and conservative attitudes in the formation of a person’s (...) long-term orientation and consequent ethical beliefs. Empirically testing these hypothesized relationships using data from 292 subjects, we find that long-term perspectives on tradition and planning indeed engender higher levels of ethical values. The results also support work ethic’s role in fostering tradition and planning, as well as conservatism’s positive association with planning. Additionally, we report how tradition and planning mediate the influence of conservatism and work ethic on the formation of ethical values. Limitations of the study and future research directions, as well as implications for business managers and academics, are also discussed. (shrink)

ObjectivePatient involvement is used to describe the inclusion of patients as active participants in healthcare decision-making and research. This study aimed to investigate incoming year 1 medical (MBChB) students’ attitudes and opinions regarding patient involvement in this context.MethodsWe established a staff–student partnership to formulate the design of an online research survey, which included Likert scale questions and three short vignette scenarios designed to probe student attitudes towards patient involvement linked to existing legal precedent. Incoming year 1 medical students (n=333) were (...) invited to participate in the survey before formal teaching commenced.ResultsSurvey data (49 participants) indicate that students were broadly familiar with, and supportive of, patient involvement in medical treatment. There was least support for patient involvement in conducting (23.9%), contributing to (37.0%) or communicating research (32.6%), whereas there was unanimous support for patients choosing treatment from a selection of options (100%).ConclusionIncoming members of the medical profession demonstrate awareness of the need to actively involve patients in healthcare decision-making but are unfamiliar with the utility and value of such involvement in research. Further empirical studies are required to examine attitudes to patient involvement in healthcare. (shrink)

Recently, we reported that melanoma risk in redheads is linked not only to pale skin, but also to the synthesis of the pigment – called pheomelanin – that gives red hair its color. We demonstrated that pheomelanin synthesis is associated with increased oxidative stress in the skin, yet we have not uncovered the chemical pathway between the molecule pheomelanin and the DNA damage that drives melanoma formation. Here, we hypothesize two possible pathways. On one hand, pheomelanin might generate reactive oxygen (...) species (ROS) that directly or indirectly cause oxidative DNA damage. On the other hand, pheomelanin synthesis might consume cellular antioxidant stores and make the cell nucleus more vulnerable to other endogenous ROS. Uncovering the mechanistic pathway between pheomelanin and oxidative DNA damage will be an important step in developing strategies to lower melanoma risk in redheads. (shrink)

Although underappreciated in his own day, Catholic convert John Henry Newman was remarkably prophetic about the challenges that lay ahead for the Catholic faith. In his 1873 sermon titled, ‘The Infidelity of the Future’, Newman warned of a time when the Church would face not only the cold indifference of agnosticism but also the targeted hostility of those opposed to both God and religion. Yet Newman was not without hope or wisdom for the future Church. This essay examines Newman's insistence (...) upon the need to cultivate an ‘ecclesiastical spirit’ and an ‘intelligent faith’. It specifically explores how Catholic institutions of higher education can respond to Newman's call and assist in bringing about a renewal in the evangelical mission of the Church, providing a much-needed alternative to the wisdom of the world. (shrink)

Internet-based health research is increasing, and often offers financial incentives but fraudulent behavior by participants can result. Specifically, eligible or ineligible individuals may enter the study multiple times and receive undeserved financial compensation. We review past experiences and approaches to this problem and propose several new strategies. Researchers can detect and prevent Internet research fraud in four broad ways: through the questionnaire/instrument ; through participants' non-questionnaire data and seeking external validation through computer information,, and 4) through study design. These approaches (...) each have pros and cons, and raise ethical, legal, and logistical questions, given that ethical tensions can emerge between preserving the integrity of research vs. protecting the privacy and confidentiality of study respondents. While past discussions concerning the ethics of online research have tended to focus on the participants' ability to trust the researchers, needs now arise to examine researchers' abilities to trust the participants. This analysis has several critical implications for future practice, policy, and research. (shrink)

Bioethics, Volume 36, Issue 5, Page 535-546, June 2022.

Focal brain metabolic effects detected by proton magnetic resonance spectroscopy (MRS) in obsessive-compulsive disorder (OCD) represent prospective indices of clinical status and guides to treatment design. Sampling bilateral pregenual anterior cingulate cortex (pACC), anterior middle cingulate cortex (aMCC), and thalamus in 40 adult patients and 16 healthy controls, we examined relationships of the neurometabolites glutamate+glutamine (Glx), creatine+phosphocreatine (Cr), and choline-compounds (Cho) with OCD diagnosis and multiple symptom types. The latter included OC core symptoms (Yale-Brown Obsessive-Compulsive Scale - YBOCS), depressive symptoms (...) (Montgomery-Åsberg Depression Rating Scale - MADRS), and general functioning (Global Assessment Scale - GAS). pACC Glx was 9.7% higher in patients than controls. Within patients, Cr and Cho correlated negatively with YBOCS and MADRS, while Cr correlated positively with the GAS. In aMCC, Cr and Cho correlated negatively with MADRS, while Cr in thalamus correlated positively with GAS. These findings present moderate support for glutamatergic and cingulocentric perspectives on OCD. Based on our prior metabolic model of OCD, we offer one possible interpretation of these group and correlational effects as consequences of a corticothalamic state of elevated glutamatergic receptor activity alongside below-normal glutamatergic transporter activity. (shrink)

This paper is one of four interrelated action papers resulting from the 2008 National Summit on Legal Preparedness for Obesity Prevention and Control. Summit participants engaged in discussions on the current state of the law with respect to obesity, nutrition and food policy, physical activity, and physical education. Participants also identified gaps in the law at all jurisdictional levels and relevant to numerous sectors and disciplines that have a stake in obesity prevention and control.The companion paper, “Assessment of Laws and (...) Legal Authorities for Obesity Prevention and Control,”identified numerous laws and policies enacted to target the three domains of healthy lifestyles, healthy places, and healthy societies. That paper identified several gaps in the law that require attention and action. This paper addresses those gaps and presents applicable laws and legal authorities that public health professionals and lawyers can consider to implement to close the gaps. (shrink)

This chapter examines the romanitas of the Codex Amiatinus. It suggests that the choice of uncial script in Northumbria in the 660s and 670s was a political act and that the association of uncial script with Rome and the papal mission acted as a challenge to insular liturgical gospel-book traditions in Northumbria. The chapter analyses the romanitas of Wearmouth-Jarrow, assuming that Bishop Wilfrid's romanitas aimed to demonstrate to the Northumbrians the superiority of Rome over Iona and of St. Peter over (...) Columba. (shrink)

This volume is a collection of 16 essays, old and new, relating history and exegesis in the writings of Bede and Adomnán, and in the lives of Thomas Becket. The first part consists of seven studies of Bede's writings, notably his biblical commentaries and his Ecclesiastical History. Two of the essays are published here for the first time. The five studies in the second part, devoted to Adomnán, discuss his life of Saint Columba (the Vita Columbae) and his guide to (...) the Holy Places (De locis sanctis). One essay ('The Bible as Map'), published posthumously, compares his presentation of a major theme, the earthly and heavenly Jerusalem, with the approach adopted by Bede. The third section consists of two essays on the lives of Thomas Becket that were composed shortly after his death. They examine, in the context of patristic exegesis, the biblical images invoked in the texts in order to show how the saint's biographers understood the complex relationship between hagiography and history. With the exception of the Jarrow Lecture on Bede and the essays on Becket, the studies in both parts were published originally in edited books, some of them now hard to come by. (shrink)

ABSTRACTThis study examines the types of verbal, pictorial, and multimodal metaphors in the genre of sex education picture books for young children in Mainland China. Although being an educational discourse genre that is essentially concerned with transmitting scientific facts, sex education picture books employ a range of metaphors that categorize and construe the biological knowledge of human reproduction in a way that not only facilitates young children’s understanding of scientific concepts but also instills in them particular values and moralities that (...) are socioculturally conditioned. An examination of the source domains from which the metaphors are drawn and the target domains onto which the metaphors are mapped reveals three types of metaphor, namely, personification, domestication, and cross-experience metaphors. The analysis of seven sex education picture books for pre-school children suggests that these types of metaphor are used purposefully for addressing pedagogical as well as ideological con... (shrink)

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

This article provides a critical appraisal of the case for healthcare being rationed away from older patients to those who are younger. After sketching a metaphysics of elderliness and reviewing clinical and economic cases for healthcare rationing, the article looks in depth at the most challenging case for age rationing known as the ‘fair innings’ case. This article rejects that case and makes an alternative case that fairness actually dictates against age rationing in favour of allocation on the basis of (...) need. It concludes with a call for a renewed ‘covenant between generations’, founded on the virtue of pietas. (shrink)

Objective: Ethical guidelines are designed to ensure benefits, protection and respect of participants in clinical research. Clinical trials must now be registered on open-access databases and provide details on ethical considerations. This systematic survey aimed to determine the extent to which recently registered clinical trials report the use of standard of care and post-trial obligations in trial registries, and whether trial characteristics vary according to setting. Methods: We selected global randomized trials registered on http://www.clinicaltrials.gov and http://www.controlled-trials.com. We searched for intervention (...) trials of HIV/AIDS, malaria, and tuberculosis from 9 October 2004, the date of the most recent version of the Helsinki Declaration, to 10 April 2007. Results: We collected data from 312 trials. Fifty-eight percent (58%, 95% CI = 53 to 64) of trial protocols report informed consent. Fifty-eight percent (58%, 95% CI = 53 to 64) of trials report active controls. Almost no trials (1%, 95% CI = 0.5 to 3) mention post-trial provisions. Most trials measure surrogate outcomes. Twenty percent (20%, 95% CI = 16 to 25) of trials measure patient-important outcomes, such as death; and the odds that these outcomes are in a low income country are five times greater than for a developed country (odds ratio (OR) 5.03, 95% CI = 2.70 to 9.35, p = < 0.001). Pharmaceutical companies are involved in 28% (CI = 23 to 33) of trials and measure surrogate outcomes more often than nonpharmaceutical companies (OR 2.45, 95% CI = 1.18 to 5.09, p = 0.31). Conclusion: We found a large discrepancy in the quality of reporting and approaches used in trials in developing settings compared to wealthier settings. (shrink)

Controversy persists over the ethics of compensating research participants and providing posttrial benefits to communities in developing countries. Little is known about residents' views on these subjects. In this study, interviews about compensation and posttrial benefits from a hypothetical HIV vaccine trial were conducted in Uganda’s Rakai District. Most respondents said researchers owed the community posttrial benefits and research compensation, but opinions differed as to what these should be. Debates about posttrial benefits and compensation rarely include residents' views like these, (...) but future ones should. (shrink)

There have been calls for mandatory vaccination legislation to be introduced into the UK in order to tackle the national and international rise of vaccine-preventable disease. While some countries have had some success associated with mandatory vaccination programmes, the Royal College of Paediatrics and Child Health insist this is not a suitable option for the UK, a country which has seen historical opposition to vaccine mandates. There is a lack of comprehensive data to demonstrate a direct link between mandatory vaccination (...) legislation and increased uptake. While there are examples whereby there has been an improvement, some studies suggest that comparable results can be obtained by strongly recommending vaccinations instead. The RCPCH insist that healthcare workers are ideally placed to engage and inform parents to make every interaction a ‘vaccine opportunity’. This paper calls for a principled, rational approach to interpretations of autonomy which underpin parental informed consent. MacLean’s concept of mutual persuasion could be a vehicle to ensuring parents are suitably informed of both the material risks associated with vaccine choices and to consider the rationality of their decisions, while ultimately upholding parental autonomy. It is argued that this, alongside infrastructural improvement, could create a more sustainable, long-term improvement in childhood vaccination rates in the UK than mandatory vaccination. (shrink)

The AI and Society discourse has previously drawn attention to the ways that digital systems embody the values of the technology development community from which they emerge through the development and deployment process. Research shows how this effect leads to a particular treatment of gender in computer systems development, a treatment which lags far behind the rich understanding of gender that social studies scholarship reveals and people across society experience. Many people do not relate to the narrow binary gender options (...) of male or female, and many people express their gender identity in much richer ways than the sex/gender binary female/woman and male/man Boolean terms will allow. We ask: are “born-digital” gendered datasets in digital systems experienced as marginalising by those who express their identity beyond the male/female binary? Case Study: Ireland. To answer this universal question, this paper presents the findings of an empirical case study of people in Ireland with diverse gender identities and expressions, and their experiences with public data systems and new technologies. In spite of great social changes in Ireland which have led to constitutional change in favour of LGBTQI + people, born-digital systems were experienced by respondents as embodying socio-cultural values which were no longer accepted in society at large. For many of the respondents, digital technologies routinely marginalise them in all kinds of ways. These systems keep alive violence and oppression long after civil rights have been enshrined in constitutional law. This study is just one example of the way assumptions about digital are disengaged from society-at-large. It is a call to arms to all who are passionate about socially-responsible technology. (shrink)

Law is an essential tool for public health practice, and the use of a systematic legal framework can assist with preventing chronic diseases and addressing the growing epidemic of obesity.The action options available to government at the federal, state, local, and tribal levels and its partners can help make the population healthier by preventing obesity and decreasing the growing burden of associated chronic diseases such as cardiovascular disease and Type 2 diabetes. The Centers for Disease Control and Prevention uses the (...) four-part systematic legal framework commonly referred to as “public health legal preparedness” to demonstrate the essential role law can play for any public health issue. This paper uses the “laws and legal authorities” component of the framework and should be considered in combination with the competencies, coordination, and information-best practices components of the framework. (shrink)

By recognizing symbols of research culture in postgraduate medical education, educators and trainees can gain a deeper understanding of the existing culture and mechanisms for its transformation. First, I identify symbolic manifestations of the research culture through a case narrative of a single anesthesia residency program, and I offer a visual conceptualization of the research culture. In the second part, I theorize the application of Senge’s (1994) disciplines of a learning organization and discuss leverage for enhancing research culture. This narrative (...) account is offered to inform the work of enhancing the broader research culture in postgraduate medical education. (shrink)

Disturbances of consciousness, including fluctuations in attention and awareness, are a common and clinically important symptom in dementia with Lewy bodies. In the present study we investigate potential mechanisms of such disturbances of consciousness in a clinicopathological study evaluating specific components of the cholinergic system. [3H]Epibatidine binding to the high-affinity nicotinic receptor in the temporal cortex differentiated DLB cases with and without DOC, being 62–66% higher in those with DOC. The were no differences between DLB patients with or without DOC (...) in 125I-labeled α-bungaratoxin binding to the low-affinity nicotinic receptor, [3H]pirenzepine binding to the muscarinic M1 receptor, or in choline acetyltransferase activity. These findings provide support for the hypothesis that cholinergic activity is an important neural correlate if consciousness and suggest a mechanism of DOC in DLB involving alterations in the nicotinic receptor, composed of predominantly α4 and β2 subunits. (shrink)

In this study, we explore the relationship between perceived CEO greed and workplace safety. Drawing on insights from the social psychology literature, we theorize that CEOs are cognizant that their perceived greed has implications for how observers respond to failures in workplace safety. Our theorizing points to a somewhat counterintuitive positive relationship between perceived CEO greed and workplace safety. Consistent with our theorizing, we find that the relationship is attenuated when the CEO is insulated from how observers respond to firm (...) conduct and is amplified when the CEO’s characteristics have a larger impact on how observers respond to adverse firm-level events. We contribute to business ethics research on executive greed, on the relationship between CEO traits and (ir)responsible corporate conduct, and on the antecedents of workplace safety. (shrink)

PurposeEven low intensity exercise bouts of at least 15 min can improve feelings of energy and reduce systolic blood pressure. However, little is known about the psychological outcomes of briefer exercise bouts, particularly for modes of exercise that are more intense than level walking, and readily available to many working adults. This study assessed the effects of a 4-min bout of stair walking on FOE and feelings of fatigue.MethodsThirty-six young adult participants were randomized to either stair walking or seated control (...) groups. All participants walked on level-ground from a laboratory to a nearby stairwell and were seated for 4 min before beginning their experimental condition. Stair-walking participants walked up and down one flight of 16 stairs at their own pace for 4 min, while control participants remained seated during that time. Participants walked back to the laboratory for post-condition assessments. Measures of blood pressure, heart rate, rated perceived exertion, and the intensity of feelings of mental energy, mental fatigue, physical energy, and physical fatigue were assessed pre-and post-condition. Separate one-way ANOVAs were conducted on change scores for all variables.ResultsThe stair climbing group experienced significant increases in heart rate [F = 13.167, p < 0.001] and RPE [F = 93.844, p < 0.001] that were not observed in the seated control group. Four minutes of self-paced stair climbing resulted in small changes and non-significant differences within and between groups in blood pressure as well as FOE and FOF.ConclusionAlthough a 4-min self-paced exercise bout can convey short-term physiological health benefits, a 4-min bout of self-paced indoor stair walking in a stairwell was insufficient to lower blood pressure or change subjective FOE and fatigue in a sample that exhibited better than typical FOE and FOF at the pre-test. (shrink)