Silence has gained a prominent role in the field of psychotherapy because of its potential to facilitate a plethora of therapeutically beneficial processes within patients’ inner dynamics. This study examined the phenomenon from a conversation analytical perspective in order to investigate how silence emerges as an interactional accomplishment and how it attains interactional meaning by the speakers’ adjacent turns. We restricted our attention to one particular sequential context in which a patient’s turn comes to a point of possible completion and (...) receives a continuer by the therapist upon which a substantial silence follows. The data collection consisted of 74 instances of such post-continuer silences. The analysis revealed that silence can retroactively become part of a topic closure sequence, can become shaped as an intra-topic silence, and can be explicitly characterized as an activity in itself that is relevant for the therapy in process. Only in this last case, the absence of talk is actually treated as disruptive to the ongoing talk. Although silence is often seen as a therapeutic instrument that can be implemented intentionally and purposefully, our analysis demonstrated how it is co-constructed by speakers and indexically obtains meaning by adjacent turns of talk. In the ensuing turns, silence indeed shows to facilitate access to the patient’s subjective experience at unconscious levels. (shrink)

Historians of the Roman Empire have been nearly unanimous in giving the ill-fated Caesar whom Hadrian designated as his successor the cognomen Verus ascribed to him by Spartianus.2 Following the same biographer Annalists have given the names Aurelius and Annius to his father and grandfather. Noris in his Epistola Consularis3 maintained against Pagi that the original names of this prince were Lucius Ceionius Commodus, that neither he nor any of his family bore the names Aurelius, Annius, or Verus ascribed to (...) them in the Historia Augusta, but that the name Verus has been mistakenly reflected upon him from his more famous son L. Verus Augustus the colleague of M. Aurelius Antoninus. De Tillemont4 rejected Noris’ opinion on purely literary grounds, saying, ‘il est bien difficile de croire qu'un auteur ait esté assez ignorant et assez malheureux pour nommer toujours un prince, mesme en faisant exprès son histoire, d'un nom qu'il n'a jamais eu.’ By consequence the mistake, if mistake it be, is become inveterate and is repeated5 down to our own day. Klebs6 alone rejects the jiame, and the error is not corrected in Dr. Bury's edition of Gibbon. (shrink)

This new edition brings Farquharson's authoritative 1944 translation up to date and includes a helpful introduction and notes for the student and general reader. Rutherford includes a selection of letters from Marcus to his tutor Fronto--most of which date from his earlier years--that offer personal detail and help to fill out the somber portrait of the emperor that is found in the Meditations.

Moral Case Deliberations are reflective dialogues with a group of participants on their own moral dilemmas. Although MCD is successful as clinical ethics support, it also has limitations. 1. Lessons learned from individual MCDs are not shared in order to be used in other contexts 2. Moral learning stays limited to the participants of the MCD; 3. MCD requires quite some organisational effort, 4. MCD deals with one individual concrete case. It does not address other, similar cases. These limitations warrant (...) research into complementary ways of providing CES to healthcare professionals. Our research objective was therefore to develop a low threshold CES tool based on a series of MCDs on autonomy in long-term care. We used a qualitative research design in which we analyzed the process and content of a series of MCDs, combined with reflections on the theoretical background of MCD. In total 28 MCDs were analyzed by means of a thematic content analysis. In various rounds of development, the results of the analysis were combined with theoretical reflections on CES. Consequently, the tool was evaluated in three focus groups and adjusted. The CES tool, called ‘moral compass’, guides the users through a series of six subsequent questions in order to methodically reflect on their concrete moral dilemma, in the form of a booklet of 23 pages. It combines a methodical element that encourages and structures a reflection process with a substantive element, including norms, values, options, strategies, and insights regarding dealing with client autonomy. By using data from a series of MCDs, combined with theoretical reflections on MCD, ethics support and moral learning, we developed a thematic, low-threshold CES tool that supports healthcare professionals in daily practice in dealing with moral questions regarding client autonomy. It integrates examples and insights from earlier MCDs on the same topic. The moral compass is not a replacement of, but can be used complementary to MCD. The feasibility and impact of the moral compass need to be investigated in an evaluative follow-up study. The methodology presented in this paper may be used to develop moral compasses on different topics in various healthcare organizations. (shrink)

In biological electron transport the spin, and thus the magnetic property of electrons, is neglected. Furthermore, no attention is paid to the fact that the great majority of biologically important molecules are chiral, and during excitation a magnetic moment is induced in them. It is shown, both theoretically and experimentally, that the magnetic moment of the electron and the magnetic transition moment of the optically active molecules may interact. The main consequences of such an interaction are a higher probability of (...) the occurrence of optically active molecules in triplet states, and the polarization of transported electrons. (shrink)

I desire to invite the attention of students of Plato and of Greek mathematics to a solution of a passage which has long been a field of controversy for critics. For brevity's sake I shall take for granted an acquaintance with the two solutions which at present dispute the field, and further adopt certain positions which previous enquirers have established beyond reasonable doubt.

This is the first of four papers to be published in Research Ethics Review in 2009 that address methodological issues of relevance to research ethics committees. These will be practical papers, intended to assist ethics committee members to determine whether a research method is both ethically justified and likely to lead to high quality research. This paper prepares the way for the series through a consideration of the relationship between research ethics and methodology.

© 2014 Taylor Francis. The Centers for Disease Control and Prevention recommends routine human immunodeficiency virus testing of every client presenting for services in venues where HIV prevalence is high. Because older adults have particularly poor prognosis if they receive their diagnosis late in the course of HIV disease, any screening provided to younger adults in these venues should also be provided to older adults. We examined aging-related disparities in recent and ever HIV testing in a probability sample of at-risk (...) adults seeking services in needle exchange sites, sexually transmitted disease clinics, and Latino community clinics that provide HIV testing. Using multiple logistic regression with generalized estimating equations, we estimated associations between age category and each HIV testing outcome. Even after controlling for covariates such as recent injection drug use, older adults had 40% lower odds than younger adults did of having tested in the past 12 months or ever. Aging-related disparities in HIV testing exist among clients of these high HIV prevalence venues and may contribute to known aging-related disparities in late diagnosis of HIV infection and poor long-term prognosis. (shrink)

To investigate the current status of hospital clinical ethics committees (CEC) and how they have evolved in Canada over the past 20 years, this paper presents an overview of the findings from a 2008 survey and compares these findings with two previous Canadian surveys conducted in 1989 and 1984. All Canadian hospitals over 100 beds, of which at least some were acute care, were surveyed to determine the structure of CEC, how they function, the perceived achievements of these committees and (...) opinions about areas with which CEC should be involved. The percentage of hospitals with CEC in our sample was found to be 85% compared with 58% and 18% in 1989 and 1984, respectively. The wide variation in the size of committees and the composition of their membership has continued. Meetings of CEC have become more regularised and formalised over time. CEC continue to be predominately advisory in their nature, and by 2008 there was a shift in the priority of the activities of CEC to meeting ethics education needs and providing counselling and support with less emphasis on advising about policy and procedures. More research is needed on how best to define what the scope of activities of CEC should be in order to meet the needs of hospitals in Canada and elsewhere. More research also is needed on the actual outcomes to patients, families, health professionals and organisations from the work of these committees in order to support the considerable time committee members devote to this endeavour. (shrink)

I claim that Mill has a theory of poetry which he uses to reconcile nineteenth century associationist psychology, the tendency of the intellect to dissolve associations, and the need for educated members of society to desire utilitarian ends. The heart of the argument is that Mill thinks reading poetry encourages us to feel the feelings of others, and thus to develop pleasurable associations with the pleasurable feelings of others and painful associations with the painful feelings of others. Once the associations (...) are developed, they are supported and maintained by our natural capacity for sympathy and by external elements in society, and provide motivation for the pursuit of utilitarian ends. Further, the additional support causes the associations to be strengthened to the extent that they come to be seen as ‘natural and necessary’, and as such are immune from the dissolving force of the intellect. (shrink)

In this consensus report by a diverse group of academics who conduct and/or are concerned about social and behavioral genomics (SBG) research, the authors recount the often‐ugly history of scientific attempts to understand the genetic contributions to human behaviors and social outcomes. They then describe what the current science—including genomewide association studies and polygenic indexes—can and cannot tell us, as well as its risks and potential benefits. They conclude with a discussion of responsible behavior in the context of SBG research. (...) SBG research that compares individuals within a group according to a “sensitive” phenotype requires extra attention to responsible conduct and to responsible communication about the research and its findings. SBG research (1) on sensitive phenotypes that (2) compares two or more groups defined by (a) race, (b) ethnicity, or (c) genetic ancestry (where genetic ancestry could easily be misunderstood as race or ethnicity) requires a compelling justification to be conducted, funded, or published. All authors agree that this justification at least requires a convincing argument that a study's design could yield scientifically valid results; some authors would additionally require the study to have a socially favorable risk‐benefit profile. (shrink)