Some participants will get HIV-infected in HIV prevention trials, despite risk reduction measures. The subsequent treatment responsibilities of sponsor-investigators have been widely debated, especially where access to antiretroviral therapy (ART) is not available. In this paper, we explore two accounts of beneficence to establish whether they can shed light on sponsor-investigator responsibilities. We find the notion of general beneficence helpful insofar as it clarifies that some beneficent actions will be obligatory where they can be dispensed without scuppering the trial. We (...) find the notion of specific beneficence helpful insofar as it directs investigators to attend to the needs of trial participants; however the range of interventions that could be provided remains unhelpfully broad. We then examine accounts of the investigator-participant relationship to narrow the range of interventions that investigators should provide, concluding that health-care, and HIV infection, are appropriate foci. We conclude that when investigators are able to meet the ART needs of their participants (e.g. referral, assisted referral or direct provision) without sacrificing trial quality, they must do so. However, there is little of this explicit direction to be found in the account of specific beneficence itself, but rather it is found in accounts of the relationship that are compatible with beneficence. (shrink)

Many prescriptions offered in the literature for enhancing creativity and innovation in organizations raise ethical concerns, yet creativity researchers rarely discuss ethics. We identify four categories of behavior proffered as a means for fostering creativity that raise serious ethical issues: breaking rules and standard operating procedures; challenging authority and avoiding tradition; creating conflict, competition and stress; and taking risks. We discuss each category, briefly identifying research supporting these prescriptions for fostering creativity and then we delve into ethical issues associated with (...) engaging in the prescribed behavior. These four rubrics illustrate ethical issues that need to be incorporated into the creativity and innovation literature. Recommendations for how organizations can respond to the ethical issues are offered based on practices of exemplary organizations and theories of organizational ethics. A research agenda for empirically investigating the ethical impact these four categories of behavior have on organizations concludes the article. (shrink)

Although introns in 5′‐ and 3′‐untranslated regions (UTRs) are found in many protein coding genes, rarely are they considered distinctive entities with specific functions. Indeed, mammalian transcripts with 3′‐UTR introns are often assumed nonfunctional because they are subject to elimination by nonsense‐mediated decay (NMD). Nonetheless, recent findings indicate that 5′‐ and 3′‐UTR intron status is of significant functional consequence for the regulation of mammalian genes. Therefore these features should be ignored no longer.

The presence of fetal cells has been associated with both positive and negative effects on maternal health. These paradoxical effects may be due to the fact that maternal and offspring fitness interests are aligned in certain domains and conflicting in others, which may have led to the evolution of fetal microchimeric phenotypes that can manipulate maternal tissues. We use cooperation and conflict theory to generate testable predictions about domains in which fetal microchimerism may enhance maternal health and those in which (...) it may be detrimental. This framework suggests that fetal cells may function both to contribute to maternal somatic maintenance (e.g. wound healing) and to manipulate maternal physiology to enhance resource transmission to offspring (e.g. enhancing milk production). In this review, we use an evolutionary framework to make testable predictions about the role of fetal microchimerism in lactation, thyroid function, autoimmune disease, cancer and maternal emotional, and psychological health.Also watch the Video Abstract. (shrink)

Recently, a number of experiments have emphasized the degree to which subjects fail to detect large changes in visual scenes. This finding, referred to as “change blindness,” is often considered surprising because many people have the intuition that such changes should be easy to detect. Levin, Momen, Drivdahl, and Simons documented this intuition by showing that the majority of subjects believe they would notice changes that are actually very rarely detected. Thus subjects exhibit a metacognitive error we refer to as (...) “change blindness blindness.” Here, we test whether CBB is caused by a misestimation of the perceptual experience associated with visual changes and show that it persists even when the pre- and postchange views are separated by long delays. In addition, subjects overestimate their change detection ability both when the relevant changes are illustrated by still pictures, and when they are illustrated using videos showing the changes occurring in real time. We conclude that CBB is a robust phenomenon that cannot be accounted for by failure to understand the specific perceptual experience associated with a change. (shrink)

Research on language processing has shown that the disruption of conceptual integration gives rise to specific patterns of event-related brain potentials —N400 and P600 effects. Here, we report similar ERP effects when adults performed cross-domain conceptual integration of analogous semantic and mathematical relations. In a problem-solving task, when participants generated labeled answers to semantically aligned and misaligned arithmetic problems, the second object label in misaligned problems yielded an N400 effect for addition problems. In a verification task, when participants judged arithmetically (...) correct but semantically misaligned problem sentences to be “unacceptable,” the second object label in misaligned sentences elicited a P600 effect. Thus, depending on task constraints, misaligned problems can show either of two ERP signatures of conceptual disruption. These results show that well-educated adults can integrate mathematical and semantic relations on the rapid timescale of within-domain ERP effects by a process akin to analogical mapping. (shrink)

This study examines steroid production in fathers watching their children compete, extending previous research of vicarious success or failure on men’s hormone levels. Salivary testosterone and cortisol levels were measured in 18 fathers watching their children play in a soccer tournament. Participants completed a survey about the game and provided demographic information. Fathers with higher pregame testosterone levels were more likely to report that referees were biased against their children’s teams, and pre- to postgame testosterone elevation was predicted by watching (...) sons compete rather than daughters as well as perceptions of unfair officiating. Pregame cortisol was not associated with pregame testosterone or with perceived officiating bias, but cortisol did fluctuate synergistically with testosterone during spectator competition. Although fathers showed no consistent testosterone change in response to winning or losing, pregame testosterone may mediate steroid hormone reactivity to other aspects of their children’s competition. (shrink)

The self-disorder model provides a phenomenological framework for understanding how the core symptoms of Schizophrenia Spectrum Disorders (SSDs) are rooted in an instability of minimal selfhood. This instability involves a range of “anomalous experiences”: transformations in an individual’s perceptual field and sense of being an agent of action. The explanatory value of this theoretical model can be summarized in two claims about the role of anomalous experiences in self-disorders: (1) anomalous experiences express a common trait-like disturbance that is characteristic of (...) SSDs, and (2) anomalous experiences contribute to explanations regarding how self-disorders progress into SSDs. While hypotheses consistent with the first claim have been substantiated in several studies, hypotheses consistent with the second claim remain underexamined. We argue that attending to this gap in the literature requires considering which methodological strategies are best suited for investigating if and how anomalous experiences contribute to the development of self-disorders into SSDs and psychotic states. Network modeling is discussed as one such strategy suitable for examining the role of anomalies of lived-world in the maintenance of paranoid delusions in SSDs. (shrink)

To promote ethical practices, healthcare managers must understand the ethical challenges encountered by key stakeholders. To characterize ethical challenges in Veterans Administration facilities from the perspectives of managers, clinicians, patients, and ethics consultants. We conducted focus groups with patients and managers ; semi-structured interviews with managers, clinicians, and ethics committee chairpersons. Data were analyzed using content analysis. Managers reported that the greatest ethical challenge was fairly distributing resources across programs and services, whereas clinicians identified the effect of resource constraints on (...) patient care. Ethics committee chairpersons identified end-of-life care as the greatest ethical challenge, whereas patients identified obtaining fair, respectful, and caring treatment. Perspectives on ethical challenges varied depending on the respondent's role. Understanding these differences can help managers take practical steps to address these challenges. Further, ethics committees seemingly, are not addressing the range of ethical challenges within their institutions. (shrink)

Introduction: Although deep brain stimulation often improves levodopa-responsive gait symptoms, robust therapies for gait dysfunction from Parkinson's disease remain a major unmet need. Walking speed could represent a simple, integrated tool to assess DBS efficacy but is often not examined systematically or quantitatively during DBS programming. Here we investigate the reliability and functional significance of changes in gait by directional DBS in the subthalamic nucleus.Methods: Nineteen patients underwent unilateral subthalamic nucleus DBS surgery with an eight-contact directional lead in the most (...) severely affected hemisphere. They arrived off dopaminergic medications >12 h preoperatively and for device activation 1 month after surgery. We measured a comfortable walking speed using an instrumented walkway with DBS off and at each of 10 stimulation configurations at the midpoint of the therapeutic window. Repeated measures of ANOVA contrasted preoperative vs. maximum and minimum walking speeds across DBS configurations during device activation. Intraclass correlation coefficients examined walking speed reliability across the four trials within each DBS configuration. We also investigated whether changes in walking speed related to modification of step length vs. cadence with a one-sample t-test.Results: Mean comfortable walking speed improved significantly with DBS on vs. both DBS off and minimum speeds with DBS on. Pairwise comparisons showed no significant difference between DBS off and minimum comfortable walking speed with DBS on. Intraclass correlations were ≥0.949 within each condition. Changes in comfortable walk speed were conferred primarily by changes in step length.Conclusion: Acute assessment of walking speed is a reliable, clinically meaningful measure of gait function during DBS activation. Directional and circular unilateral subthalamic DBS in appropriate configurations elicit acute and clinically significant improvements in gait dysfunction related to PD. Next-generation directional DBS technologies have significant potential to enhance gait by individually tailoring stimulation parameters to optimize efficacy. (shrink)

BackgroundYouth are increasingly aware of the negative effects of climate change on the planet and human health, but this knowledge can often come with significant affective responses, such as psychological distress, anger, or despair. Experiencing major “negative” emotions, like worry, guilt, and hopelessness in anticipation of climate change has been identified with the term eco-anxiety. Emerging literature focuses on adults' experience; however, little is known about the ways in which children and youth experience eco-anxiety.ObjectivesThe aim of this review was to: (...) identify the available evidence on the topic of eco-anxiety in children, clarify the mental health consequences brought by the awareness of climate change in this population, and identify knowledge gaps in the literature and considerations for future research.MethodsGiven that the research on the topic of eco-anxiety in children is limited, that there are very few randomized controlled trials, and that the goal is not to analyze individual studies in-depth, a scoping review was used. Keywords pertaining to the themes of eco-anxiety, climate change and children were used as search terms in five databases. Journal articles using qualitative and quantitative methods, as well as gray literature were examined by two independent reviewers. A descriptive-analytical method was used to chart the data that emerged from the literature. Eighteen articles were considered in the final analysis.ResultsEvidence confirms that children experience affective responses and eco-anxiety in reaction to then awareness of climate change. Mental health outcomes include depression, anxiety, and extreme emotions like sadness, anger, and fear. Youth from vulnerable communities, like indigenous communities, or those who have strong ties to the land are often identified as being emotionally impacted by climate change. The literature analyzed also describes how children and youth are coping with eco-anxiety, including maladaptive and adaptive responses. Preliminary considerations for parents, teachers and educators, mental health care providers, school systems, adults and people of power include adding age-appropriate climate education to the school curriculum, considering youth's emotions, and promoting healthy coping through empowerment. Important gaps exist in the definition of eco-anxiety in youth, as various characterizations of this emerging concept are found across articles. (shrink)

This chapter contains sections titled: An Economic Model of Carroll Towing Relaxing the Model's Initial Assumptions Efficiency as a Norm Some Limitations of Law and Economics Conclusion References.

Programs, policies, and technologies — particularly those concerned with health equity — are often designed with justice envisioned as the end goal. These policies or interventions, however, frequently fail to recognize how the beneficiaries have historically embodied the cumulative effects of marginalization, which undermines the effectiveness of the intended justice. These well-meaning attempts at justice are bounded by greater socio-historical constraints. Bounded justice suggests that it is impossible to attend to fairness, entitlement, and equity when the basic social and physical (...) infrastructures underlying them have been eroded by racism and other historically entrenched isms. Using the case of Brazil’s National Health Policy for the Black Population, this paper proposes that bounded justice can contribute to justice discourses by serving as a concept, a proffering to a multi-disciplinary conceptual framework, and a potential analytic for those interested in the design of policy, technology, and programmatic interventions towards health equity. (shrink)

Competition among scientists for funding, positions and prestige, among other things, is often seen as a salutary driving force in U.S. science. Its effects on scientists, their work and their relationships are seldom considered. Focus-group discussions with 51 mid- and early-career scientists, on which this study is based, reveal a dark side of competition in science. According to these scientists, competition contributes to strategic game-playing in science, a decline in free and open sharing of information and methods, sabotage of others’ (...) ability to use one’s work, interference with peer-review processes, deformation of relationships, and careless or questionable research conduct. When competition is pervasive, such effects may jeopardize the progress, efficiency and integrity of science. (shrink)

As policy makers place great hope in health information technology as a means to lower costs and achieve improvements in health care quality, safety, and efficiency, organizations at the forefront of building health information exchange networks attempt to weave the concept and function of informed consent into an evolving information-driven health care system. The vast amount of information that will become available to both health professionals and patients in the new HIT-driven environment can reasonably be expected to affect the relationship (...) between them in many ways, particularly in the area of informed consent. During this early stage of HIT adoption, it is critical that we engage in discussions regarding informed consent’s proper role in a heretofore unknown health care environment — one in which electronic information sharing holds primary importance. The central and largely unexamined question of whether and how the legal and ethical underpinnings of informed consent will fit into the context of HITenabled treatment is critical to both public policy and clinical practice. (shrink)

The nature of scientific societies’ relationships with their members limits their ability to promote research integrity. They must therefore leverage their strengths as professional organizations to integrate ethical considerations into their ongoing support of their academic disciplines. This paper suggests five strategies for doing so.

Reflective essay focusing on a discussion of friendship with a group of fourth grade students. Includes a brief discussion of a learning game that focuses on the problems of listening to others.

In this response essay, I borrow a page from Jack Halberstam to explore the ties that bind—ligates, as in re-ligio—the two sibling fields of sociology and religious studies.

This article explains the problems with Alan Shewmon’s critique of brain death as a valid sign of human death, beginning with a critical examination of his analogy between brain death and severe spinal cord injury. The article then goes on to assess his broader argument against the necessity of the brain for adult human organismal integration, arguing that he fails to translate correctly from biological to metaphysical claims. Finally, on the basis of a deeper metaphysical analysis, I offer a revised (...) rationale for the validity of the neurological criterion of human death. (shrink)

This article discusses the concept of publicity in Kant’s moral philosophy. Insofar as the concepts of ‘public’ and ‘private’ can describe our relations with others, they can be considered to be moral concepts. I argue that we can find in Kant a moral duty not to keep our maxims of action private, or secret. Whereas Korsgaard argues that sometimes in the face of evil it is permissible to sidestep the moral law, I argue that it is rather through publicity that (...) we can deal with evil in the non-ideal world. Moreover, by being open with our maxims, moral progress is possible. View HTML Send article to KindleTo send this article to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle. Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service.Making the Ideal Real: Publicity and Morality in KantVolume 21, Issue 2Melissa Zinkin DOI: https://doi.org/10.1017/S1369415416000042Your Kindle email address Please provide your Kindle [email protected]@kindle.com Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Dropbox To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox. Making the Ideal Real: Publicity and Morality in KantVolume 21, Issue 2Melissa Zinkin DOI: https://doi.org/10.1017/S1369415416000042Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Google Drive To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive. Making the Ideal Real: Publicity and Morality in KantVolume 21, Issue 2Melissa Zinkin DOI: https://doi.org/10.1017/S1369415416000042Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Export citation. (shrink)

Globalization generates new structures of human interdependence and vulnerability while also posing challenges for models of democracy rooted in territorially bounded states. The diverse phenomena of globalization have stimulated two relatively new branches of political theory: theoretical accounts of the possibilities of democracy beyond the state; and comparative political theory, which aims at bringing non-Western political thought into conversation with the Western traditions that remain dominant in the political theory academy. This article links these two theoretical responses to globalization by (...) showing how comparative political theory can contribute to the emergence of new global “publics” around the common fates that globalization forges across borders. Building on the pragmatist foundations of deliberative democratic theory, it makes a democratic case for comparative political theory as an architecture of translation that helps deliberative publics grow across boundaries of culture. (shrink)

SummaryThis article documents understandings and responses to mass drug administration for the treatment and prevention of lymphatic filariasis among adults and children in northern coastal Tanzania from 2004 to 2011. Assessment of village-level distribution registers, combined with self-reported drug uptake surveys of adults, participant observation and interviews, revealed that at study sites in Pangani and Muheza districts the uptake of drugs was persistently low. The majority of people living at these highly endemic locations either did not receive or actively rejected (...) free treatment. A combination of social, economic and political reasons explain the low uptake of drugs. These include a fear of treatment ; divergence between biomedical and local understandings of lymphatic filariasis; and limited and ineffective communication about the rationale for mass treatment. Other contributory factors are the reliance upon volunteers for distribution within villages and, in some locations, strained relationships between different groups of people within villages as well as between local leaders and government officials. The article also highlights a disjuncture between self-reported uptake of drugs by adults at a village level and the higher uptake of drugs recorded in official reports. The latter informs claims that elimination will be a possibility by 2020. This gives voice to a broader problem: there is considerable pressure for those implementing MDA to report positive results. The very real challenges of making MDA work are pushed to one side – adding to a rhetoric of success at the expense of engaging with local realities. It is vital to address the kind of issues raised in this article if current attempts to eliminate lymphatic filariasis in mainland coastal Tanzania are to achieve their goal. (shrink)

This paper demonstrates that accounting for the moral harm of selecting for deafness is not as simple or obvious as the widespread negative response from the hearing community would suggest. The central questions addressed by the paper are whether our moral disquiet with regard to selecting for deafness can be adequately defended, and if so, what this might entail. The paper considers several different strategies for accounting for the supposed moral harm of selecting for deafness and concludes that the deaf (...) case cannot be treated in isolation. Accounting for the moral harm of selecting for deafness necessarily entails moral implications for other cases of procreation and procreative decision-making, including unassisted coital reproduction. The lesson to be learned from the deaf case is that we need norms that govern not just the use of reproductive technology, but procreation and procreative decision-making in all of its various forms. (shrink)

Researchers are studying how artificial intelligence (AI) can be used to better detect, prognosticate and subgroup diseases. The idea that AI might advance medicine’s understanding of biological categories of psychiatric disorders, as well as provide better treatments, is appealing given the historical challenges with prediction, diagnosis and treatment in psychiatry. Given the power of AI to analyse vast amounts of information, some clinicians may feel obligated to align their clinical judgements with the outputs of the AI system. However, a potential (...) epistemic privileging of AI in clinical judgements may lead to unintended consequences that could negatively affect patient treatment, well-being and rights. The implications are also relevant to precision medicine, digital twin technologies and predictive analytics generally. We propose that a commitment to epistemic humility can help promote judicious clinical decision-making at the interface of big data and AI in psychiatry. (shrink)

As is clear in the 2008 report of the President's Council on Bioethics, the brain death debate is plagued by ambiguity in the use of such key terms as ‘integration’ and ‘wholeness’. Addressing this problem, I offer a plausible ontological account of organismal unity drawing on the work of Hoffman and Rosenkrantz, and then apply that account to the case of brain death, concluding that a brain dead body lacks the unity proper to a human organism, and has therefore undergone (...) a substantial change. I also show how my view can explain hard cases better than one in which biological integration is taken to imply ontological wholeness or unity. (shrink)

The android Data from Star Trek admired human emotion whereas Spock viewed emotion as irrational and maladaptive. The theory that emotions fulfil adaptive functions is widely accepted in academic psychology but little is known about laypeople’s theories. The present study assessed the extent to which laypeople share Data’s view of emotion as helpful or Spock’s view of emotion as a hindrance. We also assessed how help and hinder theory endorsement were related to reasoning, emotion regulation, and well-being. Undergraduates completed a (...) stressful timed reasoning task and questionnaires that assessed their theories of emotion, emotion regulation strategies, happiness, and social support. Overall, participants viewed emotion more as a help than a hindrance. The more they endorsed the view that emotion helps, the better their reasoning scores. Endorsing a help theory also predicted the use of reappraisal which, in turn, predicted greater happiness and social support. In contrast, endorsing the view that emotion hinders was associated with emotion suppression and less social support. Thus, people’s theories about the functionality of emotion may have important implications for their reasoning and emotional well-being. (shrink)

This article examines how geologists, botanists, and ecologists used pollen as a proxy for past climates in the first half of the twentieth century. It focuses on a particular challenge of measuring climate with pollen: pollen’s mobility. As scientists came to learn, pollen from some vegetation is more mobile than others. Pollen’s differential mobility challenged regional climatic conclusions because of the potential mixing of pollen from various locations. To minimize the effects of this problem, pollen analysts sought to decrease the (...) noise produced by highly local or foreign pollen. Yet, many ground-truthing and calibration methods were not available to pollen analysts because of the temporal separation between the observer and the object of interest. Instead, pollen analysts had to make spatial meaning out of fossil pollen using empirical studies of modern pollen, inferences from macrofossils and successional history, and applying statistical theories to fossil pollen data. Many of these corrections factors relied on pollen analysts’ knowledge of place, including elements like the location’s topography, prevailing winds, and plant cover. These elements were a natural part of vegetation-pollen-climate interactions. Scientists needed to account for them to turn pollen into a proxy for climate. Pollen’s movement was equally natural, but scientists decided to eliminate some pollen to augment the regional climate signal. These selective eliminations of place suggest that not all elements of place are equally important. Scientists had to omit some elements of place to make sense of the complexities of the natural world. (shrink)

Farmers’ willingness and ability to adapt to climate change are in part influenced by their social networks and sources of information. Drawing on assemblage theory and social network analysis in a novel way, this study explores the influence of Oregonian small farmers’ social and informational networks on their beliefs about and responses to climate change. The use of assemblage theory, which focuses on many disparate elements as they co-function in a space, allows for multiple entities within farmers’ networks and the (...) ways they interact to be examined, while the use of social network analysis highlights broader patterns in the structure and composition of farmers’ networks. Theoretically, this study brings these two distinct yet similar bodies of theory and methodologies together for the first time to expand the utility of both fields and explore farmers’ networks in a novel way. Results indicate that small farmers’ connections to other farmers and media in their networks are influencing their beliefs about climate change, while their responses are influenced by their ties to various agricultural and climatological information sources, as well as other nearby farmers. Finally, while farmers’ ties to other farmers are largely limited to those nearby, certain central individuals and entities, particularly beginning farmers, can act as bridges linking distinct groups of farmers. An understanding of these networks can be used to better disseminate critical information, such as forecasts and adaptation strategies, to help farmers adapt. (shrink)

In this paper, I argue that brain death is death because, despite the appearance of genuine integration, the brain-dead body does not in fact possess the unity that is proper to a human organism. A brain-dead body is not a single entity, but a multitude of organs and tissues functioning in a coordinated manner with the help of artificial life support. In order to support this claim, I first lay out Hoffmann and Rosenkrantz’s ontological account of the requirements for organismal (...) unity and summarize an earlier paper in which I apply this account to the brain death debate. I then further support this ontological argument by developing an analogy between the requirements for the unity of an organism and the requirements for the unity of an orchestra. To do so, I begin by examining the role that a conductor plays in unifying a traditional orchestra, and then go on to show that the human organism functions like a traditional orchestra that relies upon a conductor for its unity. Next, I consider the conditions required to achieve orchestral unity in conductorless orchestras and show that, in contrast to simpler organisms like plants, the postnatal human organism lacks those conditions. I argue, in other words, that although conductorless orchestras do exist, the human organism is not one of them. Like a traditional orchestra without a conductor, the brain-dead body is not a unified whole. (shrink)