Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is (...) associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:594 Feminist Studies 41, no. 3. © 2015 by Feminist Studies, Inc. Liberty Walther Barnes and Christin L. Munsch The Paradoxical Privilege of Men and Masculinity in Institutional Review Boards In the 1939 Hollywood classic The Wizard of Oz, the great wizard admonishes Dorothy and her friends to “pay no attention to that man behind the curtain.” Dorothy and company turn to see a man standing before a (...) large control panel operating the smoke, holographic image, and voice of the great wizard. Realizing he has been discovered, the man gives up manipulating the switches and the nebulous wizard vanishes.1 Hegemonic masculinity is analogous to the “all-powerful” wizard.2 In order to maintain its grandeur, power, and mystique, the mechanics of masculine ideology—as well as the social actors who participate in its reproduction —must be kept hidden.3 A crucial aim of feminist research is to 1. The Wizard of Oz, directed by Victor Fleming (Culver City, CA: Metro-Goldwyn -Mayer, 1939). 2. See R. W. Connell, Masculinities: Knowledge, Power and Social Change (Berkeley : University of California Press, 1995); R. W. Connell and James W. Messerschmidt, “Hegemonic Masculinity: Rethinking the Concept,” Gender & Society 19 (2005): 829–61; Michael Kaufman, “Me, Feminism, and Men’s Contradictory Experiences of Power,” in Theorizing Masculinities, ed. Harry Brod and Michael Kaufman (Thousand Oaks, CA: Sage Publications, 1994), 142– 63; and Michael S. Kimmel, “Masculinity as Homophobia: Fear, Shame, and Silence in the Construction of Gender Identity” in Brod and Kaufman, Theorizing Masculinities, 119–42. 3. Michael Flood and Bob Pease, “Undoing Men’s Privilege and Advancing Gender Equality in Public Sector Institutions,” Policy and Society 24, no. 4 (2005): 119–38; Allan G. Johnson, The Gender Knot: Unraveling Liberty Walther Barnes and Christin L. Munsch 595 pull back the curtain on men’s lives and masculine institutions in order to demystify socially constructed masculinities, particularly in their most powerful forms. As early feminist scholars note, male privilege renders women’s lives invisible.4 But male privilege renders aspects of men’s lives invisible, too. In this article we highlight how institutional review boards (IRBs) in universities and hospitals erect barriers to research that render particular aspects of men’s lives invisible. We draw on our experiences of submitting ten applications for a series of methodologically diverse studies of masculinity to eight IRBs. First, we argue that, despite their original function of protecting subordinated groups, IRBs are gendered institutions in which members base their decisions on culturally dominant, normative images of women and men. We show how this results in the stringent protection of male research participants, the safeguarding of participants’ personal masculinity, and the shielding of men’s lives from social inquiry. Second, we argue that IRBs are gendering institutions. Our experiences reveal how the privileging and protection of masculinity results in mandatory protocol modifications that idealize hegemonic masculinity. These modifications require researcher-participant interactions that socialize men to engage in gender “appropriate” behavior and reify gendered expectations. Third, our experiences reveal the ways in which IRBs protect the institution itself and privilege the universities, hospitals, and (predominantly male) medical doctors they represent. Consequently, the ways they reproduce social inequality remain impervious to academic inquiry. IRBS AS GENDERED AND GENDERING INSTITUTIONS Every university and hospital in the United States where human research is conducted houses a human research protections program, or IRB, to oversee academic research. Universities with hospitals typically our Patriarchal Legacy (Philadelphia, PA: Temple University Press, 1997); Michael Kimmel, Guyland: The Perilous World Where Boys Become Men (New York: Harper Collins, 2008). 4. Simone de Beauvoir, The Second Sex, trans. Howard M. Parshley (New York: Knopf, 1951); Sandra Harding, The Science Question in Feminism (Ithaca, NY: Cornell University Press, 1986); Dorothy E. Smith, “Women’s Perspective as a Radical Critique of Sociology,” in Feminist Perspectives on Social Research, ed. Sharlene N. Hesse-Biber and Michelle L. Yaiser (New York: Oxford University Press, 2004), 84–96. 596 Liberty Walther Barnes and Christin L. Munsch maintain two types of IRB committees: a social-behavioral committee that oversees studies in the social sciences, and a biomedical committee to supervise clinical drug trials, experimental medical treatments, and tissue and blood research. The duty of the... (shrink)

Anhedonia is a risk factor for suicide and poor treatment response in depressed individuals. Most evidence-based psychological therapies target symptoms of heightened negative affect instead of deficits in positive affect and typically show little benefit for anhedonia. Viewing positive scenes through virtual reality has been shown to increase positive affect and holds great promise for addressing anhedonic symptoms. In this pilot study, six participants with clinically significant depression completed 13 sessions of exposure to positive scenes in a controlled VR environment. (...) Significant decreases were found in self-reported anhedonia, depression, anxiety, and impairments in functioning from baseline to 1-month follow-up. Negative affect decreased over all 13 sessions, and positive affect increased over sessions 8–13. Results suggest that positive experiences in VR may be a novel avenue for the treatment of anhedonia in depressed individuals. (shrink)

This paper provides new insights into the food security performance of long and short food chains, through an analysis of the resilience of such chains during the severe weather events that occurred in the Australian State of Queensland in early 2011. Widespread flooding cut roads and highways, isolated towns, and resulted in the deaths of people and animals. Farmlands were inundated and there were food shortages in many towns. We found clear evidence that the supermarket-based food chain delivery system experienced (...) significant difficulties in supplying food to flood-affected towns. In contrast, more localized food supply chains—which relied upon supply from growers in peri-urban areas and community-based food initiatives—remained largely intact, and provided food at a time when the supermarkets were limited in their ability to respond to consumer demand. However, on closer examination of food distribution during flooding in the regional city of Rockhampton and in the State capital, Brisbane, the demarcation of success between “long” and “short” food chains became blurred. Both types of food supply chains shared some key resilience characteristics in responding to crisis but diverged in other important ways. We argue that conceptualizing food chains in terms of key elements of resilience—scale, diversity, flexibility and cohesion—may be more fruitful than the short-long dichotomy alone. This approach is particularly useful when prioritizing food security as the basis for evaluating food system sustainability in a context of predicted increases in extreme weather events and future climate change. (shrink)

This paper considers some of the curatorial devices used in exhibitions at the South End Museum in Gqeberha. The South End Museum, which opened on 3 March 2001, is modelled in several respects on the District Six Museum in Cape Town: it, too, is an urban-based, self-defined 'community museum' constituted around the histories of the apartheid Group Areas Act and the implementation of forced removals. Like many post-1994 museums in South Africa, the South End Museum relies on photographs for their (...) displays, whilst also making use of maps, a mural and reenactment. The paper considers the ways in which these different displays touch, recall, reflect and activate one another. Keeping in mind that the notion of 'community' in South Africa bears the burden of being raced by its apartheid and colonial pasts, and abiding by the spectrality that is constitutive of the image, the paper grapples with the haunted space of 'community museums' in the Eastern Cape. While the South End Museum deploys some of the same curatorial devices as the District Six Museum, and deals with related histories of forced removal, South End, it is argued, brings the relation between race, indigeneity and 'ruin' within 'community museums' into fleeting focus. (shrink)

The national ethical guidelines relevant to assisted reproductive technology have recently been reviewed by the National Health and Medical Research Council. The review process paid particular attention to the issue of non-medical sex selection, although ultimately, the updated ethical guidelines maintain the pre-consultation position of a prohibition on non-medical sex selection. Whilst this recent review process provided a public forum for debate and discussion of this ethically contentious issue, the Victorian case of JS and LS v Patient Review Panel [2011] (...) VCAT 856 provides a rare instance where the prohibition on non-medical sex selection has been explored by a court or tribunal in Australia. This paper analyses the reasoning in that decision, focusing specifically on how the Victorian Civil and Administrative Tribunal applied the statutory framework relevant to ART and its comparison to other uses of embryo selection technologies. The Tribunal relied heavily upon the welfare-of-the-child principle under the Assisted Reproductive Treatment Act 2008. The Tribunal also compared non-medical sex selection with saviour sibling selection. Our analysis leads us to conclude that the Tribunal’s reasoning fails to adequately justify the denial of the applicants’ request to utilize ART services to select the sex of their prospective child. (shrink)

This paper applies Plato's cave allegory to Enron's success and downfall. Plato's famous tale of cave dwellers illustrates the different levels of truth and understanding. These levels include images, the sources of images, and the ultimate reality behind both. The paper first describes these levels of perception as they apply to Plato's cave dwellers and then provides a brief history of the rise of Enron. Then we apply Plato's levels of understanding to Enron, showing how the company created its image (...) and presented information to support that image, and how the public eventually emerged from the cave to realize the truth about Enron's actual accounting practices and financial state, which led to the corporation's downfall. We find Plato's allegory both useful in analyzing the relationship between Enron and the public and instructive about the power and moral responsibility of Enron's executives. (shrink)

This paper applies Plato’s cave allegory to Enron’s success and downfall. Plato’s famous tale of cave dwellers illustrates the different levels of truth and understanding. These levels include images, the sources of images, and the ultimate reality behind both. The paper first describes these levels of perception as they apply to Plato’s cave dwellers and then provides a brief history of the rise of Enron. Then we apply Plato’s levels of understanding to Enron, showing how the company created its image (...) and presented information to support that image, and how the public eventually emerged from the cave to realize the truth about Enron’s actual accounting practices and financial state, which led to the corporation’s downfall. We find Plato’s allegory both useful in analyzing the relationship between Enron and the public and instructive about the power and moral responsibility of Enron’s executives. (shrink)

In June 2002, Arthur Andersen LLP became the first accounting firm in history to be criminally convicted. The repercussions were immense. From a position as one of the leading professional services firms in the world, with 85,000 staff in 84 countries and revenues in excess of $9 billion, Andersen effectively ceased to exist within a matter of months. Although Andersen’s conviction related specifically to a charge of obstructing justice, public attention focused on the audit relationship between Andersen and its major (...) client, Enron Corporation, particularly the actions (and inactions) that had allowed Enron to post spectacular year-on-year earnings and profit growth. As well as examining events leading up to the demise of Andersen, the case provides an opportunity to consider the broader controversy over accounting and corporate governance practices and, more generally, the pressures found within organisations that can foster unethical conduct. The case was prepared from public sources. (shrink)

Prenatal screening can significantly benefit parents and the community. However, it has created a dilemma for women as it requires them to quickly decide whether to continue a pregnancy or terminate it should the test indicate a foetal abnormality. This can be psychologically traumatic for women torn between their connection to an unborn child with all its possible imperfections, and a desire to prevent its suffering as a disabled child in later life. A woman must also consider her own and (...) her family's future welfare. Extensive research into the physical aspects of prenatal screening has not explored the meaning of the experience for women or whether termination is the most appropriate option. This article examines recent qualitative studies, concluding that women who terminate a pregnancy following prenatal screening may experience an acute grief reaction or be plagued by guilt and fear that can precipitate marital breakdown. Additionally, there is a risk that through striving to eradicate congenital disability, a community risks promoting a cult of perfectionism that may have discriminatory effects on disabled people. (shrink)

BackgroundPeople with upper extremity amputations report receiving insufficient information about treatment options. Furthermore, patients commonly report not knowing what questions to ask providers. A question prompt sheet, or list of questions, can support patient-centered care by empowering patients to ask questions important to them, promoting patient-provider communication, and increasing patient knowledge. This study assessed information needs among people with UE amputations about UE vascularized composite allotransplantation and developed a UE VCA-QPS.MethodsThis multi-site, cross-sectional, mixed-methods study involved in-depth and semi-structured interviews with (...) people with UE amputations to assess information needs and develop a UE VCA-QPS. Qualitative data were analyzed by thematic analysis; quantitative data were analyzed by descriptive statistics. The initial UE VCA-QPS included 130 items across 18 topics.ResultsEighty-nine people with UE amputations participated. Most were male, had a mean age of 46 years, and had a unilateral and below-elbow amputation. Participants desired information about UE VCA eligibility, evaluation process, surgery, risks, rehabilitation, and functional outcomes. After refinement, the final UE VCA-QPS included 35 items, across 9 topics. All items were written at a ≤ 6th grade reading level. Most semi-structured interview participants reported being ‘completely’ or ‘very’ likely to use a UE VCA-QPS.ConclusionPeople with UE amputations have extensive information needs about UE VCA. The UE VCA-QPS aims to address patients’ information needs and foster patient-centered care. Future research should assess whether the UE VCA-QPS facilitates patient-provider discussion and informed decision-making for UE VCA. (shrink)

Modes of rationality in nursing documentation: biology, biography, and the ‘voice of nursing’ This article is based on a discourse analysis of the complete nursing records of 45 patients, and concerns the modes of rationality that mediated text‐based accounts relating to patient care that nurses recorded. The analysis draws on the work of the critical theorist, Jürgen Habermas, who conceptualised rationality in the context of modernity according to two types: purposive rationality based on an instrumental logic, and value rationality based (...) on ethical considerations and moral reasoning. Our analysis revealed that purposive rationality dominated the content of nursing documentation, as evidenced by a particularly bio‐centric and modernist construction of the workings of the body within the texts. There was little reference in the documentation to central themes of contemporary nursing discourses, such as notions of partnership, autonomy, and self‐determination, which are associated with value rationality. Drawing on Habermas, we argue that this nursing documentation depicted the colonisation of the sociocultural lifeworld by the bio‐technocratic system. Where nurses recorded disagreements that patients had with medical regimes, the central struggle inherent in the project of modernity became transparent — the tension between the rational and instrumental control of people through scientific regulation and the autonomy of the subject. The article concludes by problematising communicative action within the context of nursing practice. (shrink)

Wilson et al. focus on one class of AGL tasks: the cognitively demanding task of detecting non‐adjacent dependencies (NADs) among items. They provide a typology of the different types of NADs in natural languages and in AGL tasks. A range of cues affect NAD learning, ranging from the variability and number of intervening elements to the presence of shared prosodic cues between the dependent items. These cues, important for humans to discover non‐adjacent dependencies, are also found to facilitate NAD learning (...) in several nonhuman animal species. (shrink)

Wilson et al. focus on one class of AGL tasks: the cognitively demanding task of detecting non‐adjacent dependencies (NADs) among items. They provide a typology of the different types of NADs in natural languages and in AGL tasks. A range of cues affect NAD learning, ranging from the variability and number of intervening elements to the presence of shared prosodic cues between the dependent items. These cues, important for humans to discover non‐adjacent dependencies, are also found to facilitate NAD learning (...) in several nonhuman animal species. (shrink)

Margaret Urban Walker’s essay ‘Getting out of line’ questions gendered assumptions about moral agency in old age and its assumed links to the concept of a ‘career self.’ In this article I develop and apply her critique to consider what forms ageing activism might take. This focuses on recognising and remembering the value of connections with people and with struggles that may both pre-date and outlive the individual. I suggest that we need to think of remembering as future as (...) well as past oriented and as political as well as personal. In developing my argument I draw from experience of working with old people in initiatives focussed on achieving change in health and social care services, on accounts of feminist activists of different generations and on personal reflections of contacts that embody both awareness of different vulnerabilities and of shared struggles for change. (shrink)

Cardiovascular disease (CVD) and sustained high blood glucose as prediabetes are an established comorbidity. People's experience in reconciling these long‐term conditions requires deeper appreciation if nurses are to more effectively support person‐centred care for people who have them. Our analysis explores the initial experience of people admitted to hospital with CVD who then find they also have sustained high blood glucose. Our methodology is informed by the philosophy of Gadamer and applies interpretive description to develop an interpretation of participant experiences. (...) The major theme emerging from participant interviews was the ‘invisible disequilibrium’ characterised by three subthemes: ‘losing equilibrium’, ‘becoming embattled’ and ‘evolving illness’. This study examines CVD and prediabetes in conjunction with the Gadamerian notion of the ‘whole’, as being in a social and emotional world in which illness is also a component part. We explore how participants lived within an ‘invisible disequilibrium’, with prediabetes frequently remaining unnoticed, while CVD was manifest. To identify multiple conditions and support effective intervention to manage them as part of person‐centric care, nursing practice should explore the ‘whole’ of the person's experience, value people’s knowledge as potential indicators of complex illness, thereby reducing the risk of accelerating complex illness. (shrink)

In the United Kingdom, the debate about how best to meet the shortfall of organs for transplantation has persisted on and off for many years. It is often presumed that the answer is simply to alter the law to a system of presumed consent. Acting perhaps on that presumption in his annual report launched in July, the Chief Medical Officer, Sir Liam Donaldson, advocated a system of organ donation based on presumed consent, the so-called “opt-out” system.1 He is calling for (...) a change in the law in England and Wales whereby consent to organ donation is presumed, making a person’s organs automatically available for transplantation after death, unless they registered objections to this while alive. Subsequently, the British Medical Association lent its support to the introduction of such a system.2 The BMA contends that “the practice of presumed consent legislation has had a significant effect on the number of cadaveric donors per million population.”2It is often taken for granted that there must be a correlation between the enactment of legislation on presumed consent and an increase in organ donation and procurement. However, the correlation is not as straightforward as it might seem. It may be that other practical measures to encourage organ donation could be implemented without changing the Human Tissue Act 2004, an Act which has been in force for barely a year.An analysis by Abadie and Gay demonstrated that “presumed consent legislation has a positive and sizeable effect on organ donation rates”,3 but they themselves admitted that the correlation between rates of donation and presumed consent legislation is “not completely unequivocal”.3 It is true that among the most successful cases in procurement rates are countries with presumed consent legislation . However, since some of the …. (shrink)

This article considers the theme of discernment in the tradition of Ignatian spirituality emanating from the Spiritual Exercises of St Ignatius of Loyola, the founder of the Society of Jesus. After a brief introduction which addresses the central problematic of bad influences that manifest themselves as good, the article turns to the life and work of two Jesuits, the 16th C English missionary to India, Thomas Stephens and the 20th C French historian and cultural critic, Michel de Certeau. Both kept (...) up a constant dialogue with local culture in which they sought authenticity in their response to ‘events’, whether a hideous massacre which shaped the pastoral commitment and writing of Stephens in the south of the Portuguese enclave of Goa or the 1968 student-led protests in Paris that so much affected the thinking of de Certeau. Very different in terms of personal background and contemporary experience, they both share in a tradition of discernment as a virtuous response to what both would understand as the ‘wisdom of the Spirit’ revealed in their personal interactions with ‘the other’. (shrink)

O artigo aborda a inclusão escolar de crianças com Transtorno do Espectro Autista (TEA), enfatizando a análise das políticas públicas no Brasil, os desafios enfrentados e as estratégias necessárias para garantir uma educação inclusiva eficaz. A problemática central está na desconexão entre as legislações que asseguram os direitos educacionais das crianças com TEA, como a Lei Berenice Piana (Lei nº 12.764/2012) e a Lei Brasileira de Inclusão (Lei nº 13.146/2015), e sua aplicação nas escolas, onde faltam infraestrutura adequada e formação (...) de professores. O objetivo é investigar as barreiras à implementação das políticas de inclusão e propor soluções para efetivá-las. A metodologia foi qualitativa e exploratória, com coleta de dados documental. Os documentos analisados incluem a Declaração de Salamanca (1994), a Política Nacional de Educação Especial (2008) e diretrizes internacionais, como as da Organização Mundial da Saúde e o DSM-5, que fornecem bases teóricas sobre o diagnóstico do TEA. Os resultados indicam que, embora haja avanços legislativos importantes, como a inclusão de crianças com TEA nas escolas regulares, a implementação ainda é insuficiente. A Lei Romeo Mion (Lei nº 14.126/2021), que equipara o Transtorno do Espectro Autista às demais deficiências para todos os efeitos legais, reforça essa necessidade, pois, além de assegurar direitos, ela busca garantir que crianças com TEA tenham os mesmos acessos e condições de aprendizado que seus colegas. No entanto, as escolas continuam enfrentando dificuldades na sua implementação prática, como a falta de treinamento especializado para professores e de recursos tecnológicos e assistivos adequados. (shrink)

ABSTRACTCommerce changes the production of wealth in a society as well as its ethics. What is appropriate in a non-commercial society is not necessarily appropriate in a commercial one. Adam Smith criticizes Stoic self-command in commercial societies, rather than embracing it, as is often suggested. He argues that Stoicism, with its promotion of indifference to passions, is an ethic appropriate for savages. Savages live in hard conditions where expressing emotions is detrimental and reprehensible. In contrast, the ease of life (...) brought about by commerce fosters the appropriate expressions and sharing of emotions. Imposing Stoicism on a commercial society is therefore imposing an ethic for savages onto a refined society – something to abhor. Smith’s rejection of Stoicism in commercial societies can thus be seen as a defence of commerce. (shrink)