Given the widening gap between the number of individuals on transplant waiting lists and the availability of donated organs, as well as the recent plateau in donations based on neurological criteria, there has been a growing interest in expanding donation after circulatory determination of death. While the prevalence of this form of organ donation continues to increase, many thorny ethical issues remain, often creating moral distress in both clinicians and families. In this article, we address one of these issues, namely, (...) the challenges surrounding patient and surrogate informed consent for donation after circulatory determination of death. First we discuss several general concerns regarding consent related to this form of organ donation, and then we address additional issues that are unique to three different patient categories: adult patients with medical decision-making capacity or potential capacity, adult patients who lack capacity, and pediatric patients. (shrink)

Somites are transient structures which represent the most overt segmental feature of the vertebrate embryo. The strict temporal regulation of somitogenesis is of critical developmental importance since many segmental structures adopt a periodicity based on that of the somites. Until recently, the mechanisms underlying the periodicity of somitogenesis were largely unknown. Based on the oscillations of c-hairy1 and lunatic fringe RNA, we now have evidence for an intrinsic segmentation clock in presomitic cells. Translation of this temporal periodicity into a spatial (...) periodicity, through somite formation, requires Notch signaling. While the Hox genes are certainly involved, it remains unknown how the metameric vertebrate axis becomes regionalized along the antero–posterior (AP) dimension into the occipital, cervical, thoracic, lumbar, and sacral domains. We discuss the implications of cell division as a clock mechanism underlying the regionalization of somites and their derivatives along the AP axis. Possible links between the segmentation clock and axial regionalization are also discussed. (shrink)

: This article describes a psychological test of Hull's (1988) theory of science as an evolutionary process by seeing if it can account for how scientists sometimes remember and cite the scientific literature. The conceptual adequacy of Hull's theory was evaluated by comparing it to Bartlett's (1932) seminal theory of human remembering. Bartlett found that remembering is an active, reconstructive process driven by a schema that biases recall in the direction of proto- typicality and personal involvement. This account supports Hull's (...) theory of science because it shows that the characteristics of reconstructive remembering are consistent with the generic properties of an evolutionary process. The empirical adequacy of Hull's theory was evaluated by comparing the predictions made from this evolutionary viewpoint against evidence from the history of science. Six cases studies of well-known psychological experiments that had been subject to repeated miscitation errors were collected and reviewed. All six case studies revealed a systematic pattern of distortions that is consistent with the schema-induced biases of reconstructive remembering. These findings support Hull's claim that science is an evolutionary process with scientists as interactors, scientific beliefs as replicators, and schemata as means for that replication. (shrink)

Abstract(1) The miscitations of seminal experiments in the base rate literature adds to the existing database of systematic miscitations of wellknown psychological experiments. These miscitations may be caused by a process of reconstructive remembering. (2) Representative design should be the methodological core of Koehler's call for ecologically valid research. This approach can benefit both basic and applied research.

Chow's monograph exhibits four prototypical symptoms of psychology's enduring scientific crisis: it equates empirical science with statistical analysis; it settles for qualitative rather than quantitative theories; it ignores the role of ecological validity in the generalizability of theories; and it puts rigid adherence to arbitrary but documentable rules over critical thinking about the meaning of results.

This study investigates the role of language in cross‐sector collaboration between mental health hospitals and municipalities, focusing on the challenges of maintaining continuity of care and integrating patient‐centered approaches. Using Fairclough's framework for critical discourse analysis, we examined focus group interviews with 21 healthcare professionals, including nurses, social workers, and psychiatrists, to identify key themes and patterns in how cross‐sector collaboration is discussed. The analysis revealed a dominant medicalized discourse in hospital settings, which often emphasized structured care processes like treatment (...) plans and medication management, overshadowing more flexible, patient‐centered approaches common in community‐based services. Power dynamics were evident, with hospital professionals frequently positioned as active agents, while patients and community‐based workers were portrayed in more passive roles. Although efforts to involve patients in decision‐making were noted, these were often controlled by professionals, reflecting a mediated approach to patient empowerment. The findings highlight the cultural and structural divides between hospital and community services and suggest the need for improved communication strategies, integrated care pathways, and a shift toward more inclusive, patient‐centered care models. Addressing these discursive barriers is crucial for achieving more effective, integrated, and patient‐centered care, ultimately improving outcomes for patients. (shrink)

Im Jahre 1998 verblüfften Andy Clark und David Chalmers die philosophische Gemeinschaft mit der so genannten These des erweiterten Geistes, die im Kern besagt, dass kognitive Systeme nicht-biologische Komponenten enthalten können und sich damit über die Grenzen biologischer Organismen hinaus erstrecken können. Die These wird seitdem nicht nur von Philosophen, sondern auch von Kognitions- und Neurowissenschaftlern intensiv und kontrovers diskutiert. In den Beiträgen, die in dem vorliegenden ersten deutschsprachigen Band zur These des erweiterten Geistes versammelt sind, werden u.a. die folgenden (...) Fragen behandelt: Was soll es heißen, dass der Geist nicht (nur) im Kopf ist? In welchem Sinne könnte er erweitert sein, und welche Möglichkeiten der Erweiterung gibt es? Welche Zusammenhänge bestehen zwischen Geist und Kognition sowie zwischen Kopplung und Konstitution? Was genau besagt der von Clark und Chalmers vorgebrachte aktive Externalismus? Welche Bedeutung hat die These des erweiterten Geistes für repräsentationalistische und für funktionalistische Theorien des Geistes sowie für Theorien kollektiver Intentionalität und sozialer Kognition? Welche Anwendungen der These könnte es geben? (shrink)

Anthony Giddens’ theory of structuration is a theory of social action, which claims that society should be understood in terms of action and structure; a duality rather than two separate entities. This paper introduces some of the central characteristics of structuration theory, presenting a conceptual framework that helps to explore how people produce the systems and structures that shape their practice. By understanding how people produce and reproduce structures, then there is the potential for changing them. Criticisms that have been (...) raised about the theory are introduced, followed by examples of how the theory might be useful to nursing research. Structuration theory can be employed to explore how nurses produce, reproduce, and transform nursing practice through social interaction across time and space. (shrink)

Postural reflexes are essential for locomotion and postural stability, and may play an important role in the etiology of chronic back pain. It has recently been theoretically predicted, and with the help of unilateral perturbations of the trunk experimentally confirmed that the sensorimotor control must lower the reflex amplitude for increasing reflex delays to maintain spinal stability. The underlying neuromuscular mechanism for the compensation of postural perturbations, however, is not yet fully understood. In this study, we applied unilateral and bilateral (...) sudden external perturbations to the trunk of healthy subjects and measured the muscular activity and the movement onset of the trunk. We found that the onset of the trunk muscle activity is prior to, or coincident with, the onset of the trunk movement. Additionally, the results of our experiments imply that the muscular response mechanism integrates distant sensory information from both sides of the body. These findings rule out a simple monosynaptic stretch reflex in favor of a more complex polysynaptic postural reflex mechanism to compensate postural perturbations. Moreover, the previously predicted negative correlation between reflex delay and reflex gain was also confirmed for bilateral perturbations. (shrink)

In this study, we elaborate connections among gender, structure, and practice to suggest how social structural relations shape social sexual practice and, in the process, reshape gender relations. Using survey data from a study of a community mobilization intervention, we investigate the connection between institutional arrangements and condom use practice in sexual encounters with commercial clients and intimate partners among 410 women engaged in sex trade in a semiurban town in southern India. Multinomial logistic regression analysis uncovers the effects of (...) 16 measures of gendered structural relations in three contexts—livelihood resources, household circumstances, and community mobilization intervention priorities. We compare women who practice either consistent or inconsistent condom use with both clients and partners with a reference group of women who practice consistent condom use with clients but not with partners. Results reveal the importance of household and community relations for consistent safer sex practice over and above the organization of sex trade. Our analysis advances gender theory in two interrelated ways: We contribute to gender theorizing in the implementation of health interventions, and to gender change more generally by thinking through possibilities emerging from recursive influences between reordered institutional configurations and altered expectations in interaction. (shrink)

Negative campaigning is a central component of political campaigns in the United States. Yet, until now, most evidence has suggested that negative campaigning has little effect on voters. How can we reconcile the findings of a plethora of empirical studies with the methods of political elites? This book cuts through to the central issue: how such advertising influences voters' attitudes and their actions during campaigns. Focusing on U.S. senatorial campaigns, Kim Fridkin and Patrick Kenney draw from surveys, experiments, facial expression (...) emotion tests, content analyses, and focus groups. They develop the "tolerance and tactics theory of negativity" and demonstrate the divergent effects of tone and content on voter outcomes. Using their new framework, they find that harsh messages seen as relevant to the opponent's ability to govern are indeed likely to be noticed and acted upon. (shrink)

In this paper we introduce the concept of d-fuzzy function which generalizes the concept of fuzzy subalgebra to a much larger class of functions in a natural way. In addition we discuss a method of fuzzification of a wide class of algebraic systems onto [0, 1] along with some consequences.

While stigmatisation is universal, stigma research in low- and middle-income countries (LMIC) is limited. LMIC stigma research predominantly concerns health-related stigma, primarily regarding HIV/AIDS or mental illness from an adult perspective. While there are commonalities in stigmatisation, there are also contextual differences. The aim of this study in DR Congo (DRC), as a formative part in the development of a common stigma reduction intervention, was to gain insight into the commonalities and differences of stigma drivers (triggers of stigmatisation), facilitators (factors (...) positively or negatively influencing stigmatisation), and manifestations (practices and experiences of stigmatisation) with regard to three populations: unmarried mothers, children formerly associated with armed forces and groups (CAAFAG), and an indigenous population. Group exercises, in which participants reacted to statements and substantiated their reactions, were held with the ‘general population’ (15 exercises, n = 70) and ‘populations experiencing stigma’ (10 exercises, n = 48). Data was transcribed and translated, and coded in Nvivo12. We conducted framework analysis. There were two drivers mentioned across the three populations: perceived danger was the most prominent driver, followed by perceived low value of the population experiencing stigma. There were five shared facilitators, with livelihood and personal benefit the most comparable across the populations. Connection to family or leaders received mixed reactions. If unmarried mothers and CAAFAG were perceived to have taken advice from the general population and changed their stereotyped behaviour this also featured as a facilitator. Stigma manifested itself for the three populations at family, community, leaders and services level, with participation restrictions, differential treatment, anticipated stigma and feelings of scapegoating. Stereotyping was common, with different stereotypes regarding the three populations. Although stigmatisation was persistent, positive interactions between the general population and populations experiencing stigma were shared as well. This study demonstrated utility of a health-related stigma and discrimination framework and a participatory exercise for understanding non-health related stigmatisation. Results are consistent with other studies regarding these populations in other contexts. This study identified commonalities between drivers, facilitators and manifestations—albeit with population-specific factors. Contextual information seems helpful in proposing strategy components for stigma reduction. (shrink)

Fowers et al. (2017)recently made a general argument for virtues as the characteristics necessary for individuals to flourish, given inherent human limitations. For example, people can flourish by developing the virtue of friendship as they navigate the inherent (healthy) human dependency on others. This general argument also illuminates a pathway to flourishing during the COVID-19 pandemic, the risks of which have induced powerful fears, exacerbated injustices, and rendered life and death decisions far more common. Contexts of risk and fear call (...) for the virtue of courage. Courage has emerged more powerfully as a central virtue among medical personnel, first responders, and essential workers. Longstanding inequalities have been highlighted during the pandemic, calling for the virtue of justice. When important personal and public health decisions must be made, the central virtue of practical wisdom comes to the fore. Wise decisions and actions incorporate the recognition of relevant moral concerns and aims, as well as responding in fitting and practical ways to the specifics of the situation. Practicing courage, justice, and practical wisdom illuminates a path to flourishing, even in a pandemic. (shrink)

Bioethics, Volume 36, Issue 1, Page 63-70, January 2022.

During somitogenesis an oscillatory mechanism termed the “segmentation” clock generates periodic waves of gene expression, which translate into the periodic spatial pattern manifest as somites. The dynamic expression of the clock genes shares the same periodicity as somitogenesis. Notch signaling is believed to play a role in the segmentation clock mechanism. The paper by Hirata et al.(1) identifies a biological clock in cultured cells that is dependent upon the Notch target gene Hes1, and which shows a periodicity similar to that (...) of the segmentation clock. This finding opens the possibility that the same oscillator mechanism might also operate in other tissues or cell types. BioEssays 25:200–203, 2003. © 2003 Wiley Periodicals, Inc. (shrink)