Executive functions (EFs) and impulsivity are dimensions of self-regulation that are both related to psychopathology. However, self-report measures of impulsivity and laboratory EF tasks typically display small correlations, and existing research indicates that impulsivity and EFs may tap separate aspects of self-regulation that independently statistically predict psychopathology in adulthood. However, relationships between EFs, impulsivity, and psychopathology may be different in childhood compared to adulthood. Here, we examine whether these patterns hold in the baseline assessment of the Adolescent Brain and Cognitive (...) Development (ABCD) sample, a national sample of over 11,000 children (including 749 twin pairs) ages 9–10 years. We examine the phenotypic and genetic relationships among latent variables for different components of EFs and multiple facets of impulsivity. Additionally, we assess how EFs and impulsivity relate to composite measures and latent variables of psychopathology derived from parent report. EFs were weakly correlated with impulsivity, and the strength varied by impulsivity facet, emphasizing their separability. We did not identify significant genetic and environmental correlations between EFs and impulsivity. Moreover, controlling for their small relationships with each other, both EFs and some facets of impulsivity statistically predicted an Externalizing factor, attention problems, and social problems, and twin analyses suggested these relationships were genetic in origin. These findings indicate that EFs and impulsivity represent phenotypically and genetically separable aspects of self-regulation that are both transdiagnostic correlates of psychopathology in childhood. (shrink)

Background: Moral distress is a kind of suffering that nurses may experience when they act in ways that are considered inconsistent with moral values, leading to a perceived compromise of moral integrity. Consequences are mostly negative and include physical and psychological symptoms, in addition to organizational implications. Objective: To psychometrically test the Moral Distress Risk Scale. Research design: A methodological study was realized. Data were submitted to exploratory factorial analysis through the SPSS statistical program. Participants and research context: In total, (...) 268 nurses from hospitals and primary healthcare settings participated in this research during the period of March to June of 2016. Ethical considerations: This research has ethics committee approval. Findings: The Moral Distress Risk Scale is composed of 7 factors and 30 items; it shows evidence of acceptable reliability and validity with a Cronbach’s α = 0.913, a total variance explained of 59%, a Kaiser–Meyer–Olkin = 0.896, and a significant Bartlett <0.001. Discussion: Concerns about moral distress should be beyond acute care settings, and a tool to help clarify critical points in other healthcare contexts may add value to moral distress speech. Conclusion: Psychometric results reveal that the Moral Distress Risk Scale can be applied in different healthcare contexts. (shrink)

The management of an infant after a decision to withdraw active treatment creates dilemmas. Both lingering death and active killing are undesirable, but palliative interventions can hasten death. We investigated what staff on our neonatal unit thought were the limits of acceptable practice and why. We administered a structured interview to elucidate their views, and asked them to justify their answers. The interviews were analysed quantitatively and qualitatively. A total of 25 participants (15 nurses and 10 doctors) were recruited. 80% (...) emphasized the importance of pain relief following withdrawal, 60% mentioned meeting parental needs at that time. 76% agreed that death can be a desired consequence of withdrawal, yet 52% felt that death should never be hastened. 96% felt that morphine is acceptable after withdrawal, and 72% would give a higher than normal dose if necessary. 56% would stop paralysis at extubation but not reverse it, while 24% would continue paralysis. 16% would consider a drug that ended life instantly in some cases. A wide variety of views emerged, but there were two main positions, a cautious majority, and a more proactive minority. Apparent contradictions within the majority position could be explained using the doctrine of double effect and the acts and omissions distinction. (shrink)

Synaesthesia is a condition in which one type of stimulation evokes the sensation of another, as when the hearing of a sound produces photisms, i.e. mental percepts of colours. R is a 20 year old colour blind subject who, in addition to the relatively common grapheme-colour synaesthesia, presents a rarely reported cross modal perception in which a variety of visual stimuli elicit aura-like percepts of colour. In R, photisms seem to be closely related to the affective valence of stimuli and (...) typically bring out a consistent pattern of emotional responses. The present case study suggests that colours might be an intrinsic category of the human brain. We developed an empirical methodology that allowed us to study the subject's otherwise inaccessible phenomenological experience. First, we found that R shows a Stroop effect (delayed response due to interference) elicited by photisms despite the fact that he does not show a regular Stroop with real colours. Secondly, by manipulating the colour context we confirmed that colours can alter R's emotional evaluation of the stimuli. Furthermore, we demonstrated that R's auras may actually lead to a partially inverted emotional spectrum where certain stimuli bring out emotional reactions opposite to the normal ones. These findings can only be accounted for by considering R's subjective colour experience or qualia. Therefore the present paper defends the view that qualia are a useful scientific concept that can be approached and studied by experimental methods. (shrink)

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)

The level of medical care to patients and the success of the implementation of the national project "Health" depend on the health status and doctor's professionalism. Modern healthcare reform is being implemented by optimizing costs, merging medical organizations, closing ineffective hospitals, expanding the use of high-tech care and informatization of the doctor's activities. All this makes it necessary to assess the health of doctors. Scientists have studied the quality of life and identified the professional burnout of doctors in children's clinics (...) in different age groups. Primary care pediatricians have a higher quality of life score when compared to the standard [1]. However, all groups have a high level of professional burnout. The pre-retirement group of doctors has more unfavorable profile. They are highly professional specialists but may experience emotional discomfort because the pension system has been reformed. This situation requires the introduction of preventive work with doctors of this age as a group with great potential and capable of professional longevity. (shrink)

This study, the third in a series of three, draws on a broader Norwegian research project exploring the phenomenon of support for young persons with mental health issues. The aim was to explore and explicate the sense of “nourishing communion”, as a somewhat neglected aspect of support. Fourteen Norwegian young adults, aged 18-25, were interviewed about their experiences of support. Data was analyzed using van Manen’s hermeneutic-phenomenological approach to open up possible meanings of how nourishing communion is concretely lived. Analysis (...) was supplemented by in-depth reflexive dialogues between the first and second author, which fostered a nourishing communion akin to the processes and dimensions of our phenomenon of interest. Findings highlight five intertwined existential themes: a) trusting the other to hold vulnerability safely; b) flourishing in mutual participation; c) acceptance in a felt togetherness; d) feeling found and received; and e) feeling an attuned resonance. The notion of “nourishing communion” as a significant but neglected element of support challenges current practice, suggesting the need for a different approach to collaboration with young persons and their networks. From the perspectives both of individual professional engagement and of policy making, there is a need for further exploration of how young persons might be supported to create and maintain a broader range of nourishing relationships. (shrink)

After a time of scientific discoveries, technological revolutions and cultural upheavals, after a time of elevation of the human genius to the highest peaks, it was time for deep anxiety for his own fragile future and the realization of the rather fragile state of many seemingly settled things. The development of the information space leads to the practice of mass indignation of the population, especially of children and adolescents, misunderstandings on the basis of economic and social achievements give rise to (...) protracted interethnic conflicts. Breakthroughs in the field of medicine often lead to repeated explosive effects in society. In addition, rapid environmental pollution has resulted from the intensive development of human activity. It should be noted that not only nature has become contaminated, but human and soul bodies and bodies become more polluted. (shrink)

This edition of Giraldus Odonis' Logica for the first time gives access to an important and original treatise, which has unduly been neglected since the author's death. It is also important in that it gives evidence of interesting achievements in the field of logic outside the anti-metaphysical circle surrounding Ockham.

In lieu of an abstract, here is a brief excerpt of the content:A Response to David Carr, “The Significance of Music for the Promotion of Moral and Spiritual Value”Iris M. YobDavid Carr has addressed a question that has been lurking in philosophical literature for centuries and, I might add, in our collective intuition as well: Just what is the connection between music and the moral and spiritual life? And as we have come to expect from his work, he brings a (...) new perspective to this perennial question in his answer. First he traces a line of thinking since Plato about music and the ordering of the soul, he touches on the role of music and the other arts in exploring the complexities of the moral imperative as it is lived out in human lives, and returns at the end to give a new take on the old Platonic idea of ordering of the soul. Just maybe, he suggests, the detachment, however temporary, "from the trials and tribulations that beset us in the day to day rough and tumble of human practical affairs" "in the interests of some more balanced perspective" on spiritual and moral matters "might be easier to achieve in the contemplation and appreciation of great works of 'music alone.'"This conclusion does not lay claim to more than what is perfectly reasonable. Allowing oneself to be immersed in a great work of music or art or architecture or dance may very well provide that distance from every day life where one might [End Page 209] re-center and refocus, refresh and renew one's outlook on the world. Such an engagement with an artwork can interrupt the patterns of thinking and acting that might have become increasingly thoughtless and ego-centric. It can be a re-creation in the true sense of the word. Paul Tillich, one of the great twentieth century religious philosophers, tells of an experience he had during the First World War where he served as a chaplain in the German army. On a brief leave from the front he visited Kaiser Friedrich Museum in Berlin and stood entranced before Botticelli's "Madonna and Child with Singing Angels." The moment was spiritually transformative, he tells us, lifting his spirits beyond the mud and grime of the battlefield to contemplate life and meaning on a different plane altogether. The experience enabled him to return to duty with renewed inner strength and calm.1 I believe this is a rather powerful and compelling example of what Carr is talking about.In coming to his conclusion, Carr is relying on the particularly difficult case of "music alone," that is, music that does not have words, title, or any other kind of representative function. In other words his argument does not depend on any didactic nature or morally or spiritually directive intent of the music. Rather, it is centered on music that ostensibly is not about anything. This is musical sound composed and performed for the appreciation of what it is in itself. And yet, in providing distance from the every day world, according to Carr, it can give expression to "realms of spiritual experience that lie beyond the sensual and empirical." Here we enter the world of the metaphorical and symbolic, what Rudolf Otto would call the "irrational" or "superrational," or the realm of the Holy. While Carr does not state this explicitly I would go so far as to say that this realm of the wordless and sacred is where the spiritual and the moral are grounded and from where they draw their power.Against this background, I would like to ask how does "music alone," in the sense intended by Carr and Peter Kivy from whom he borrowed the term bring about this effect? We are unable now to ask Tillich what it was that gave the Botticelli its impact for him, but it is curious that what it did for him it most likely did not do for all the other soldiers from the front who happened upon it the way he did. Tillich would most likely explain its effect by resorting to his theory of symbols, because after all this painting does have a literal meaning that might very well have inspired him. But... (shrink)

There is a popular hypothesis that performance on implicit and explicit memory tasks reflects 2 distinct memory systems. Explicit memory is said to store those experiences that can be consciously recollected, and implicit memory is said to store experiences and affect subsequent behavior but to be unavailable to conscious awareness. Although this division based on awareness is a useful taxonomy for memory tasks, the authors review the evidence that the unconscious character of implicit memory does not necessitate that it be (...) treated as a separate system of human memory. They also argue that some implicit and explicit memory tasks share the same memory representations and that the important distinction is whether the task (implicit or explicit) requires the formation of a new association. The authors review and critique dissociations from the behavioral, amnesia, and neuroimaging literatures that have been advanced in support of separate explicit and implicit memory systems by highlighting contradictory evidence and by illustrating how the data can be accounted for using a simple computational memory model that assumes the same memory representation for those disparate tasks. (shrink)

This volume of the Amsterdam edition of the Latin texts of Erasmus contains several works intended for scholarship in Classics. It includes discourse on the correct pronunciation of Latin and Greek, rhetoric, and Classical Latin, in a compendium of the handbook by Lorenzo Valla, as well as a declamation in praise of medicine.

Concussion is a common, serious injury in youth ice hockey, affecting up to 25% of players per season by one estimate. • Bodychecking is a major cause of injury and concussion in hockey, yet some Canadian provinces allow players as young as nine years to engage in bodychecking. • Reducing rates of concussion requires eliminating bodychecking for all except elite hockey players aged 16 years and older, as per the recommendations of the Canadian Academy of Sports and Exercise Medicine.