A discussion of ethical decision-making literature is overdue. In this article, we summarize the current literature of ethical decision-making models used in mental health professions. Of 1,520 articles published between 2001 and 2020 that met initial search criteria, 38 articles were included. We report on the status of empirical evidence for the use of these models along with comparisons, limitations, and considerations. Ethical decision-making models were synthesized into eight core procedural components and presented based on the composition of steps present (...) in each model. This taxonomy provides practitioners, trainers, students, and supervisors relevant information regarding ethical decision-making models. (shrink)

Gray's integration of the different levels of description and explanation in his theory is problematic: The introduction of consciousness into his theorising consists of the mind-brain identity assumption, which tells us nothing new. There need not be correlations between levels of description. Gray's account does not extend beyond “brute” correlation. Integration must be achieved in a principled, mutually constraining way.

Numerous experiments have examined whether moving stimuli capture spatial attention but none have sought to determine whether visual features of looming and receding objects are extracted in a capacity-free manner. The current experiment used the task-choice procedure originated by Besner and Care to examine this possibility. Stimuli were presented in 3D space by manipulating retinal disparity. Results indicate that features of an object are extracted in a capacity-free manner for both looming and receding objects for participants who consciously perceive motion (...) but not for participants who do not consciously perceive motion. These results suggest that the cognitive system is biased to process potentially animate objects, perhaps because of the evolutionary advantage this cognitive ability may provide. (shrink)

Management plays an important role in reinforcing ethics in organizations. To support this aim, managers must use incentive and goal programs in ethical ways. This study examines experimentally the potential ethical costs associated with incentive-driven and goal-induced employee behavior from a managerial perspective. In a quasi-experimental setting, 243 MBA students with significant professional work experience evaluated a hypothetical employee’s ethical behavior under incentive pay systems modeled on a business case. In the role of the employee’s manager, participants evaluated the ethicality (...) of the employee’s incentive-driven and goal-induced ethical/unethical behavior and the outcomes of behavior, with consequences that were either favorable or unfavorable to the organization. The results indicated that participants discounted the ethical considerations of incentive-driven and goal-induced behavior when consequences were favorable to the organization. Participants’ morals and outcome orientations were also significantly related to their ethical judgments and intentions to intervene. The implications of these findings for research and practice are discussed. (shrink)

Calls are increasing for American health care to be organized as a learning health care system, defined by the Institute of Medicine as a health care system “in which knowledge generation is so embedded into the core of the practice of medicine that it is a natural outgrowth and product of the healthcare delivery process and leads to continual improvement in care.” We applaud this conception, and in this paper, we put forward a new ethics framework for it. No such (...) framework has previously been articulated. The goals of our framework are twofold: to support the transformation to a learning health care system and to help ensure that learning activities carried out within such a system are conducted in an ethically acceptable fashion. (shrink)

We take up the challenge of developing an international network with capacity to survey the world's scientists on an ongoing basis, providing rich datasets regarding the opinions of scientists and scientific sub-communities, both at a time and also over time. The novel methodology employed sees local coordinators, at each institution in the network, sending survey invitation emails internally to scientists at their home institution. The emails link to a ‘10 second survey’, where the participant is presented with a single statement (...) to consider, and a standard five point Likert scale. In June 2023, a group of 30 philosophers and social scientists invited 20,085 scientists across 30 institutions in 12 countries to participate, gathering 6,807 responses to the statement 'Science has put it beyond reasonable doubt that COVID-19 is caused by a virus'. The study demonstrates that it is possible to establish a global network to quickly ascertain scientific opinion on a large international scale, with high response rate, low opt-out rate, and in a way that allows for significant (perhaps indefinite) repeatability. Measuring scientific opinion in this new way would be a valuable complement to currently available approaches, potentially informing policy decisions and public understanding across diverse fields. (shrink)

We take up the challenge of developing an international network with capacity to survey the world’s scientists on an ongoing basis, providing rich datasets regarding the opinions of scientists and scientific sub-communities, both at a time and also over time. The novel methodology employed sees local coordinators, at each institution in the network, sending survey invitation emails internally to scientists at their home institution. The emails link to a ‘10 second survey’, where the participant is presented with a single statement (...) to consider, and a standard five-point Likert scale. In June 2023, a group of 30 philosophers and social scientists invited 20,085 scientists across 30 institutions in 12 countries to participate, gathering 6,807 responses to the statement Science has put it beyond reasonable doubt that COVID-19 is caused by a virus. The study demonstrates that it is possible to establish a global network to quickly ascertain scientific opinion on a large international scale, with high response rate, low opt-out rate, and in a way that allows for significant (perhaps indefinite) repeatability. Measuring scientific opinion in this new way would be a valuable complement to currently available approaches, potentially informing policy decisions and public understanding across diverse fields. (shrink)

Calls are increasing for American health care to be organized as a learning health care system, defined by the Institute of Medicine as a health care system “in which knowledge generation is so embedded into the core of the practice of medicine that it is a natural outgrowth and product of the healthcare delivery process and leads to continual improvement in care.” We applaud this conception, and in this paper, we put forward a new ethics framework for it. No such (...) framework has previously been articulated. The goals of our framework are twofold: to support the transformation to a learning health care system and to help ensure that learning activities carried out within such a system are conducted in an ethically acceptable fashion. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

It is well known that saturation of ideals is closely related to the “antichain-catching” phenomenon from Foreman–Magidor–Shelah [10]. We consider several antichain-catching properties that are weaker than saturation, and prove:If${\cal I}$is a normal ideal on$\omega _2 $which satisfiesstationary antichain catching, then there is an inner model with a Woodin cardinal;For any$n \in \omega $, it is consistent relative to large cardinals that there is a normal ideal${\cal I}$on$\omega _n $which satisfiesprojective antichain catching, yet${\cal I}$is not saturated. This provides a negative (...) answer to Open Question number 13 from Foreman’s chapter in the Handbook of Set Theory. (shrink)

We develop the theory of layered posets and use the notion of layering to prove a new iteration theorem is κ-cc, as long as direct limits are used sufficiently often. This iteration theorem simplifies and generalizes the various chain condition arguments for universal Kunen iterations in the literature on saturated ideals, especially in situations where finite support iterations are not possible. We also provide two applications:1 For any n≥1, a wide variety of <ωn−1-closed, ωn+1-cc posets of size ωn+1 can consistently (...) be absorbed by quotients of saturated ideals on ωn.2 For any n∈ω, the tree property at ωn+3 is consistent with Chang’s conjecture ↠. (shrink)

Derrida frequently comments on the need to read and reread the texts of the tradition, to be always starting again with them. In On Touching – Jean-Luc Nancy Derrida offers another reading of (he starts again with) Aristotles's De Anima. By paying attention to the play of the palintropic, diaphanous, exactitude and ‘penser’ in Derrida's text, this paper seeks to show how important Aristotle is for Derrida in this book and in any deconstruction of the sense of touch. *.

This empirical investigation showed that contrary to the popular notion that apologies signify weakness, the victims of mistakes made by leaders consistently perceived leaders who apologized as more transformational than those who did not apologize. In a field experiment (Study 1), male referees who were perceived as having apologized for mistakes made officiating hockey games were rated by male coaches (n = 93) as more transformational than when no apology was made. Studies 2 (n = 50) and 3 (n = (...) 224) replicated this effect in two vignette studies to enhance internal and ecological validity. Contrary to expectations in Study 3, there were no apology×leader gender interactions. Theoretical and practical implications are discussed. (shrink)

Bien que Leibniz maintienne que l'examination de l'œuvre de William King, De l'origine du mal, « auroit fourni une bonne occasion d'eclaircir plusieurs difficultés » (GP VI, 400) traitées dans la Théodicée, aucun commentateur n'a encore considéré l'appendice de la Théodicée qui traite du livre de King. Dans cet éssai, je cherche à combler cette lacune. Je commence par présenter le problème de la liberté exploité par Bayle dans le Dictionnaire historique et critique afin de monter l'irrationalité de la foi, (...) et j'esquisse la conception de la liberté présentée dans la Théodicée. Dans la seconde partie de l'éssai, je présente la conception de la liberté défendue par King, avant d'examiner, dans la troisième partie de l'éssai, la critique Leibnizienne de cette conception de la liberté. Dans la dernière partie de l'éssai, j'explique comment ce traitement de l'œuvre de King renforce les arguments de la Théodicée. (shrink)

I recently visited the Soviet Union. I was there for only one week, as a tourist: time to get only a very limited and superficial impression of life there. Nevertheless, it was a sobering and thought-provoking experience. For even such a brief visit forces one to confront the problems raised by the evidently unideal character of the Soviet Union and other `actually existing' socialist societies. These are amongst the greatest problems facing socialists in the world today.

I discuss the early history of holography and explore how perceptions, applications, and forecasts of the subject were shaped by prior experience. I focus on the work of Dennis Gabor (1900–1979) in England,Yury N. Denisyuk (1927-2005) in the Soviet Union, and Emmett N. Leith (1927–2005) and Juris Upatnieks (b. 1936) in the United States. I show that the evolution of holography was simultaneously promoted and constrained by its identification as an analog of photography, an association that influenced its assessment by (...) successive audiences of practitioners, entrepreneurs, and consumers. One consequence is that holography can be seen as an example of a modern technical subject that has been shaped by cultural influences more powerfully than generally appreciated. Conversely, the understanding of this new science and technology in terms of an older one helps to explain why the cultural effects of holography have been more muted than anticipated by forecasters between the 1960s and 1990s. (shrink)

In this clear, accessible guide, Sean Hand sets Levinas's work in its intellectual and social contexts and examines: the influence of phenomenology and Judaism ...

Neonatal intensive care units represent simultaneously one of the great success stories of modern medicine, and one of its most controversial developments. One particularly controversial issue is the resuscitation of extremely preterm infants. Physicians in the United States generally accept that they are required to resuscitate infants born as early as 25 weeks and that it is permissible to resuscitate as early as 22 weeks. In this article, I question the moral pressure to resuscitate by criticizing the idea (...) that resuscitation in this context “saves” a human life. Our radical medical advancements have allowed us to intervene in the life of a human before it makes sense to say that such an intervention “saves” someone; rather, what the physician does in resuscitating and treating an extremely preterm infant is to take over creating it. This matters, I argue, because “rescues” are much more morally urgent than “creations.”. (shrink)

Magnetic resonance imaging (MRI) can provide a number of measurements relevant to sport-related concussion (SRC) symptoms; however, most studies to date have used a single MRI modality and whole-brain exploratory analyses in attempts to localize concussion injury. This has resulted in highly variable findings across studies due to wide ranging symptomology, severity and nature of injury within studies. A multimodal MRI, symptom-guided region-of-interest (ROI) approach is likely to yield more consistent results. The functions of the cerebellum and basal ganglia transcend (...) many common concussion symptoms, and thus these regions, plus the white matter tracts that connect or project from them, constitute plausible ROIs for MRI analysis. We performed diffusion tensor imaging (DTI), resting-state functional MRI, quantitative susceptibility mapping (QSM), and cerebral blood flow (CBF) imaging using arterial spin labeling (ASL), in youth aged 12-18 years following SRC, with a focus on the cerebellum, basal ganglia and white matter tracts. Compared to controls similar in age, sex and sport (N= 20), recent SRC youth (N= 29; MRI at 8 ± 3 days post injury) exhibited increased susceptibility in the cerebellum (p= 0.032), decreased functional connectivity between the caudate and each of the pallidum (p= 0.035) and thalamus (p= 0.021), and decreased diffusivity in the mid-posterior corpus callosum (p< 0.038); no changes were observed in recovered asymptomatic youth (N= 16; 41 ± 16 days post injury). For recent symptomatic-only SRC youth (N= 24), symptom severity was associated with increased susceptibility in the superior cerebellar peduncles (p= 0.011) and reduced activity in the cerebellum (p= 0.013). Fewer days between injury and MRI were associated with reduced cerebellar-parietal functional connectivity (p< 0.014), reduced activity of the pallidum (p= 0.002), increased CBF in the caudate (p= 0.005), and reduced diffusivity in the central corpus callosum (p< 0.05). Youth SRC is associated with acute cerebellar inflammation accompanied by reduced cerebellar activity and cerebellar-parietal connectivity, as well as structural changes of the middle regions of the corpus callosum accompanied by functional changes of the caudate, all of which resolve with recovery. Early MRI post-injury is important to establish objective MRI-based indicators for concussion diagnosis, recovery assessment and prediction of outcome. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bringing Cancer Care to Those who Don't Have ItLawrence N. ShulmanI have been treating cancer patients in the Harvard Medical School hospitals since 1977, and in those 35 years we have made tremendous progress. Though work still needs to be done, and far too many patients still die of cancer, many are cured. In particular, children and young adults have a high rate of cure from such diseases as (...) Hodgkin's lymphoma, non-Hodgkin's lymphoma, acute lymphoblastic leukemia, and childhood sarcoma. Patients with breast cancer in the US have a greater than 80% chance for long-term survival. The death rate from cervical cancer in the US is very low. These results have been achieved by making diagnoses earlier, in many cases surgical excision, and often systemic therapies such as chemotherapy, hormonal therapy, radiation therapy, and more recently by using so-called "targeted" therapies—those directed at particular molecular characteristics of the cancer cells.Princess Dina Mired has said that the opportunity to survive cancer should not be an accident of geography. In cases where we already have effective and inexpensive tools to cure cancer, these treatments should be considered a basic human right, a life-saving medical service.I met Patty, a young woman living in the U.S. during November of her senior year in high school, after she discovered a small lump above her left collar bone. Though she felt entirely well, she called her primary care doctor who saw her the next day, felt the enlarged lymph node, and referred her to a surgeon, who did a biopsy later that week. Her primary care doctor also called me, and we scheduled a visit when the pathology results were available. The following week the pathologist notified Patty's pediatrician that the biopsy showed Hodgkin's lymphoma. When I met Patty, she was a bright and focused young woman, waiting to hear about her college applications and enjoying her senior year. Her cancer diagnosis was completely out of context with her life as she planned it, but with the support of her family and boyfriend, she seemed prepared to take things one step at a time. A PET CT scan demonstrated a modest mass in the mediastinum (chest), but no other disease. She was in an early stage of the disease with an excellent prognosis. We recommended and administered six months of chemotherapy with doxorubicin, bleomycin, vinblastine, and dacarbazine—four chemotherapy agents that are off-patent, and relatively inexpensive. She lost her hair, not a trivial issue for her, but otherwise felt reasonably well during the treatment. She was determined to graduate with her classmates, and was able continue to attend school and keep up with her work. In June, seven months into her cancer diagnosis and treatment, she graduated with honors, and was on track to enroll in college in September.Like other 18-year-old women with Hodgkin's lymphoma, Patty had an over 80% chance for cure with the potential for a long and productive life ahead of her because we could perform a biopsy, make a diagnosis, and safely and effectively treat her with four inexpensive, off-patent, chemotherapy drugs. She had nearly the same likelihood of living a long and fruitful life as her classmates, and had the same chances for childbearing. In my line of work, with the knowledge we now possess, to allow someone like Patty to die without a chance of curative care is simply unacceptable. Treatment of curable cancers should be considered on par with the right to clean water, adequate nutrition, treatment for infectious disease, and access to maternal and child healthcare services.But in many places in the world, people with cancers we could easily eradicate in Boston have no access to cancer services, and do die unnecessarily. The local healthcare infrastructure has no [End Page E10] capacity to evaluate a patient, perform or process a biopsy, make a diagnosis, or treat the patient with potentially curative surgery, chemotherapy and radiation. I have rounded on the wards of hospitals in developing countries, stopping to talk with numerous patients like Patty: young women, some of whom might have had Hodgkin's lymphoma, but no... (shrink)

Although the popularity of Humane Education Programs as a method of teaching compassion and caring for all living beings is increasing, there is a need for rigorous, methodologically sound research evaluating the efficacy of HEP. Recent calls for the inclusion of HEP within broader humanistic, environmental, and social justice frameworks underline the importance of HEP beyond a simple “treatment of animals” model. Lack of methodological rigor in the majority of published HEP studies and dispersal across disparate fields , however, means (...) that there is a potential for the popular use of HEP to outstrip our understanding of the variables that impact efficacy. The current study discusses some of these issues and presents a pilot study of a literature-only HEP intervention. Comparisons with an age-matched control group indicated that the four-week HEP resulted in an increase in measures of empathy and treatment of animals, although only the increase in empathy levels was significant. This paper discusses the implications of the current results and areas in need of future consideration. (shrink)

Augustinian Just War Theory and the Wars in Afghanistan and Iraq: Confessions, Contentions and the Lust for Power,edited by Craig J. N. de Paulo, Senior Editor, et al. New York: Peter Lang Publishing, 2011. Details: A work concerning Augustine’s influence on Christian just war theory and the rhetoric of just war theorists from two symposia in addition to an Augustinian critique of the wars. Preface by Most Rev. Sean Cardinal O’ Malley, O.F.M. Cap., Archbishop of Boston. Foreword by Roland (...) J. Teske, S.J. Chapter One is a brief history of Augustine’s influence on the theory. Chapter Two includes a transcript of a symposium on the topic that includes the following distinguished contributors: Avery Cardinal Dulles, S.J., John D. Caputo, Most Rev. Edwin Cardinal O’Brien, Ambassador Thomas Melady, Col. Jack Jacobs, Dr. Joseph Hagan. Chapter Three includes a transcript of a colloquium on the topic that includes the following distinguished scholars and contributors: Joseph Margolis, Frederick Van Fleteren, Brian Kane, et al. (Advance Praise by James J. O’Donnell and Arthur Waldron.). (shrink)

Mounting evidence shows that nature contact is associated with affective benefits. However, the psychological mechanisms responsible for these effects are not well understood. In this study, we examined whether more time spent in nature was associated with higher levels of positive affect in general, and lower levels of negative affect and rumination in general. We also conducted a cross-sectional mediation analysis to examine whether rumination mediated the association of nature contact with affect. Participants reported their average time spent in nature (...) each week, as well as their general levels of positive and negative affect, and the degree to which they typically engaged in rumination in daily life. We then used structural equation modeling to test our hypotheses. Our results support the hypothesis that nature contact is associated with general levels of affect, and that rumination mediates this association for negative affect, and marginally mediates this association for positive affect. (shrink)

ABSTRACTMemory bias is a risk factor for depression. In two independent studies, the efficacy of one CBM-Memory session on negative memory bias and depressive symptoms was tested in vulnerable samples. We compared positive to neutral CBM-Memory trainings in highly-ruminating individuals and individuals with elevated depressive symptoms. In both studies, participants studied positive, neutral, and negative Swahili words paired with their translations. In five study–test blocks, they were then prompted to retrieve either only the positive or neutral translations. Immediately following the (...) training and one week later, we tested cued recall of all translations and autobiographical memory bias; and also measured mood, depressive symptoms, and rumination. Retrieval practice resulted in training-congruent recall both immediately after and one week after the training. Overall, there was no differential decrease in symptoms or difference in autobiographical memory bias between the tra... (shrink)

This paper examines the impact of a week-long philosophy summer camp on middle and high school-age youth with specific attention paid to the development of intellectual humility in the campers. In June 2016 a university in Texas hosted its first philosophy summer camp for youth who had just completed sixth through twelfth grades. Basing our camp on the pedagogical model of the Philosophy for Children program, our aim was specifically to develop a community of inquiry among the campers, providing them (...) with a safe intellectual space to be introduced to philosophy and philosophical discussion. In 2017 we launched a formal longitudinal study to determine what impact a week-long philosophy summer camp would have on teens and tweens. Examining quantitative and qualitative data collected from 2016–2020, we found that the camp has had a significant impact on the teenagers who have attended. In particular, we found that intellectual humility increased over the duration of their camp experience and that this increase correlates with an increased affinity for philosophy and philosophical discussion. (shrink)

Human life history is unique among primates, most notably the extraordinary length of infant dependency and the formation of long-term pair-bonds. Men and women are motivated to remain pair-bonded to maintain the distribution of male-provisioned resources to a woman and her offspring, or to protect offspring from infanticide. Men and women can employ several strategies to retain their mate and prevent their partner from defecting from the relationship, including individual mate retention (behaviors performed alone) and coalitional mate retention (behaviors performed (...) by a close ally). The current research investigates whether men and women with children perform more frequent mate retention behaviors than men and women without children. Participants (n = 1003) currently in a heterosexual romantic relationship completed a survey, reporting whether they had genetic children with their current romantic partner and how frequently they performed various mate retention behaviors. The results indicate that men (n = 262) and women (n = 234) who share genetic children with their current partner performed more frequent individual mate retention behaviors and requested more frequent coalitional mate retention behaviors than men (n = 280) and women (n = 227) who do not share genetic children with their current partner. The results are interpreted as they relate to hypotheses concerning the evolution of pair-bonding in humans, and mate retention behaviors more generally. Limitations of the current research are discussed, and profitable avenues for future research in this domain are suggested. (shrink)

In, I put forward a “possibility result” for Bayesian Coherentism, showing that there exist plausible sets of ceteris paribus conditions that imply that coherence is truth-conducive. Against this result, Schubert argues that the specific ceteris paribus conditions I consider are “jointly inconsistent”. In this article, I prove to the contrary that these conditions can consistently be enforced while allowing degrees of coherence to vary. Next, I consider a related criticism, inspired by Olsson’s constraints on ceteris paribus conditions. This leads to (...) a general discussion of the principle that should guide one in choosing appropriately stringent ceteris paribus conditions.En planteo un “resultado de posibilidad” para el bayesianismo coherentista mostrando que existen conjuntos plausibles de condiciones ceteris paribus que implican que la coherencia conduce a la verdad. Schubert argumenta en contra de este resultado que las condiciones ceteris paribus que considero son “inconsistentes tomadas conjuntamente”. En este articulo demuestro, sin embargo, que estas condiciones pueden ser satisfechas permitiendo que los grados de coherencia varien. Abordo despues una critica relacionada con la anterior e inspirada en los requisitos impuestos por Olsson a las condiciones ceteris paribus. Eso lleva a una discusion general del principio, o principios, que deberia guiarnos para elegir unas condiciones ceterisparibus que sean apropiadas, es decir, que no sean ni muy restrictivas, ni demasiado laxas. (shrink)

Intravenous drug abusers may incur bloodstream infections, in particular those involving the heart valves, that often require extended courses of antibiotics, commonly on the order of six weeks.Conventional wisdom has dictated that even when patients are sufficiently well to not need ongoing hospitalization, it is unsafe to complete their antibiotic course in any setting other than in a closely supervised facility, even if this is contrary to their wishes. The assumption has been that such patients would be at risk (...) of using their indwelling intravenous catheter for illicit purposes. Recent advances in the care of patients who suffer from addiction disorders suggest that when patients receive state-of-the-art addiction treatment, many may be able to continue their intravenous antibiotic course unsupervised, at home. This represents a departure from the parentalistic model of care of impaired patients who are prone to self-harm, moving towards a model that respects autonomy and trusts patients who are in recovery to continue their care in a manner that is self-beneficial. (shrink)

Sean Carroll has recently argued that theories predicting that observations are dominated by Boltzmann Brains should be rejected because they are cognitively unstable: “they cannot simultaneously be true and justifiably believed.” While such Boltzmann Brain theories are indeed cognitively unstable, one does not need to appeal to this argumentation to reject them. Instead, they may be ruled out by conventional Bayesian reasoning, which is sufficient to keep Boltzmann Brains at bay.

A survey of 106 medical students assessing their interest in and attitudes to medical ethics in the curriculum is reported by the authors. Results indicate that 64 per cent of the students rated the importance of medical ethics to good medical care as high or critical and 66 per cent desired to learn more about the topic. However, in reports of patient encounters identifying ethical issues, less than six per cent of the students reported a frequency of more than one (...) such patient encounter per week. The students also demonstrated a greater awareness of more obvious ethical issues than of more subtle, less publicised issues. When asked how medical ethics should be taught, the students clearly affirmed a desire for an integrated exposure to the subject throughout the medical curriculum. Possible implications of these findings for medical education are discussed. (shrink)

Western scholarly literature suggests that (1) weaning is initiated by mothers; (2) weaning takes place within a few days once mothers decide to stop nursing; (3) mothers employ specific techniques to terminate nursing; (4) semi-solid foods (gruels and mashed foods) are essential when weaning; (5) weaning is traumatic for children (it leads to temper tantrums, aggression, etc.); (6) developmental stages in relationships with mothers and others can be demarcated by weaning; and (7) weaning is a process that involves mothers and (...) children exclusively, with weaned children moving from close relationships with their mothers to strengthened relationships with other children. In many respects, these presumptions are consistent with contemporary Euroamerican practices: nursing stops early (usually before six months) relative to other cultures and takes place over a few days or weeks with the help of bottles and baby foods. Because bottles are available, weaning seldom appears traumatic, but it is seen as an important step in the establishment of independence between mothers and infants. By contrast, weaning from the bottle is often perceived as traumatic. Despite considerable academic and popular interest, weaning has seldom been studied systematically, especially in small-scale cultures. Qualitative and quantitative data from a study of Bofi foragers in Central Africa are used here to evaluate the cross-cultural applicability of the assumptions summarized above. (shrink)

BackgroundThe wellbeing of people living with dementia and their family caregivers may be impacted by stigma, changing roles, and limited access to meaningful opportunities as a dyad. Group therapeutic songwriting and qualitative interviews have been utilized in music therapy research to promote the voices of people with dementia and family caregivers participating in separate songwriting groups but not together as dyads.ProceduresThis study aimed to explore how ten people with dementia/family caregiver dyads experienced a 6-week group TSW program. Dyads participated in (...) homogenous TSW groups involving 2–4 dyads who were either living together in the community or living separately because the person with dementia resided in a care home. The TSW program, informed by personhood, couplehood, family centered and group process frameworks, involved creating original lyrics through song parody and song collage. Qualified Music Therapists facilitated sessions and interviewed each dyad separately. Interviews were analyzed using interpretative phenomenological analysis.FindingsFive recurrent group themes were developed, indicating group TSW: was a positive shared experience, benefiting both members of the dyad and motivating further engagement with music; stimulated mental processes and reignited participants’ interests and skills; provided meaningful opportunities for reflection and connection with memories and life experiences; and prompted interaction and collaboration, leading to social connections, empathic relationships and experiences of inclusion. Participants also highlighted how: the facilitated process supported engagement, highlighting abilities and challenging doubts.ConclusionDyads identified group TSW as an opportunity to recognize strengths, voice ideas and opinions, share meaningful experiences, and do “more with music.” Participants valued TSW as a new, creative and stimulating experience that enabled connection with self and others and led to feelings of pride and achievement. Our findings further recognize how therapeutic intention and approach were reflected in participants’ engagement and responses regardless of dementia stage and type, dyad relationship, or musical background. This research may broaden perspectives and expand understanding about how people with dementia and their family caregivers access and engage in music therapy. (shrink)

Background and objectives: Developmental coordination disorder is a neurodevelopmental motor disorder occurring in 5-6% of school-aged children. It is suggested that children with DCD show deficits in motor learning. Transcranial direct current stimulation enhances motor learning in adults and children but is unstudied in DCD. We aimed to investigate if tDCS, paired with motor skill training, facilitates motor learning in a pediatric sample with DCD.Methods: Twenty-eight children with diagnosed DCD were randomized and placed into a treatment or sham group. Anodal (...) tDCS was applied in conjunction with fine manual training over 5 consecutive days. Children's motor functioning was assessed with the Purdue Pegboard Test and Jebsen-Taylor Hand Function Test at baseline, post-intervention and 6 weeks following intervention. Group differences in rates of motor learning and skill transfer/retention were examined using linear mixed modeling and repeated measures ANOVAs, respectively.Results: There were no serious adverse events or drop-outs and procedures were well-tolerated. Independent of group, all participants demonstrated improved motor scores over the 5 training days [F, p < 0.001, 95% CI ], with no skill decay observed at retention. There was no interaction between intervention group and day [F, p = 0.086, 95% CI ].Conclusion: Children with DCD demonstrate motor learning with long-term retention of acquired skill. Motor cortex tDCS did not enhance motor learning as seen in other populations. Before conclusions of tDCS efficacy can be drawn, additional carefully designed trials with reproducible results are required.Clinical Trial Registration:ClinicalTrials.gov: NCT03453983. (shrink)

The Medication Event Monitoring System (MEMS) is a relatively new device designed to overcome some of the disadvantages of traditional adherence-measuring techniques. MEMS has also been found useful in tracking adherence behaviour without the need to visit patients frequently. In this study each patient was given a pre-filled, labelled MEMS bottle and cap. Patients were monitored for 24 weeks. For patients specifically studied, there were periods when drug levels may have been low and some exhibited erratic medication-taking behaviour. It (...) is concluded that MEMS can measure adherence behaviour objectively, and so might be used to improve prescribing decisions, identify drug wastage and improve carer support. Further research is needed before the routine use of electronic medication monitoring can be recommended. (shrink)

There is a paucity of treatment options for cognitively normal individuals with drug resistant genetic generalized epilepsy. Centromedian nucleus of the thalamus deep brain stimulation may be a viable treatment for GGE. Here, we present the case of a 27-year-old cognitively normal woman with drug resistant GGE, with childhood onset. Seizure semiology are absence seizures and generalized onset tonic clonic seizures. At baseline she had 4–8 GTC seizures per month and weekly absence seizures despite three antiseizure medications and vagus nerve (...) stimulation. A multidisciplinary committee recommended off-label use of CM DBS in this patient. Over 12-months of CM DBS she had two GTC seizure days, which were in the setting of medication withdrawal and illness, and no GTC seizures in the last 6 months. There was no significant change in the burden of absence seizures. Presently, just two studies clearly document CM DBS in cognitively normal individuals with GGE or idiopathic generalized epilepsy [in contrast to studies of cognitively impaired individuals with developmental and epileptic encephalopathies ]. Our results suggest that CM DBS can be an effective treatment for cognitively normal individuals with GGE and underscore the need for prospective studies of CM DBS. (shrink)

This paper addresses the potentially interactive effects of descriptive and injunctive norm perceptions on an unethical workplace behavior: counterproductive work behavior perpetration. We draw on the Focus Theory of Normative Conduct and its conceptual distinction between norm types to refine research on this topic. We also test a person-by-environment interaction to determine whether the interactive effects of these norms for CWB are enhanced among employees reporting a stronger need to belong to social groups. In two studies, predictors were assessed in (...) an initial survey and the dependent variable was assessed weeks later. Individuals employed across a range of industries served as participants. In Study 1, descriptive and injunctive norm perceptions of CWB interacted to predict CWB perpetration. This finding was replicated in Study 2. Additionally, Study 2 demonstrated that the interaction between the two norm types was especially strong among individuals high in NTB. Results suggest that to decrease CWB perpetration, organizations may profitably leverage the persuasive effects of “social norms marketing” to alter employee perceptions of the typicality and level of approval for CWBs. This is the first study to demonstrate that both descriptive and injunctive norm perceptions predict CWB perpetration. The demonstrated three-way interaction between the two norm types and NTB advances existing theory regarding the cognitive and motivational mechanisms underlying normative social influence. (shrink)

To examine the underlying processes of an innovative mind-body practice, Mindful Body Awareness, this exploratory study involved four case studies analyzed phenomenologically using the dialogal method. Mindful Body Awareness combines manual and verbal processing, and is focused on facilitation of client body awareness. Four individuals were recruited to receive weekly 1.25 hour sessions over four weeks. The Helpfulness Aspects of Therapy form was administered immediately after each session to access participants’ perceptions of the therapy experience. In addition, the Scale (...) of Body Connection was used to examine pre- and post-body awareness and bodily dissociation. Analysis involved phenomenology and descriptive statistics. The overall perceived helpfulness of the intervention was evident in the four themes that emerged from the analysis. These themes were gaining interoceptive awareness, personal agency, therapist trust and conceptual framing, and transformation. The participants’ responses were also used to investigate the therapy process across time. A pattern of increased interoceptive depth was apparent, as was a concomitant progression in embodied sense of self. Improvements in body awareness and bodily dissociation were evident for two of the four participants. These findings help to identify primary components of Mindful Body Awareness and suggest the role of these components in the embodiment process. (shrink)

In their environment, plants are continuously submitted to natural stimuli such as wind, rain, temperature changes, wounding, etc. These signals induce a cascade of events which lead to metabolic and morphogenetic responses. In this paper the different steps are described and discussed starting from the reception of the signal by a plant organ to the final morphogenetic response. In our laboratory two plants are studied: Bryonia dioica for which rubbing the internode results in reduced elongation and enhanced radial expansion and (...) Bidens pilosa for which the response occurs at distance, hence pricking the cotyledon of a plantlet induces the growth inhibition of both the hypocotyl and the axillary bud of the pricked cotyledon. Reception of the signal and transmission of the message. In Bryonia the signal is received by epidermal cells while in Bidens they are the cells adjacent to the midrib of the cotyledon which receive the mechanical signal. In both plants the message is transmitted via a wave of electric depolarization. This latter is composed of an action potential associated with a slow wave whose transmission rates are respectively 1cm s−1 and 1 mm s−1. Recent results have shown the involvement of Ca2+ in the triggering of the slow wave and the role of the H+ pump during the slow wave. Transient and fast biochemical responses. An entry of extraceilular Ca2+ into the cells and a transient increase in IP3 occur within seconds following the mechanical stimulus. At the same time, the membrane becomes more fluid, correlated with qualitative changes in phospholipids. The rapid increase in the concentration of peroxidated lipids may be correlated with ethylene biosynthesis which is stimulated after rubbing. Other parameters such as cytoplasmic pH, relative water content, hydric potential, membrane potential and modifications of K+, Mg2+-ATPase and Ca2+-ATPase activities, play a key role in the early responses induced by the traumatisms. Irreversible-biochemical responses. The mechanical stimulus performed on a Bryonia internode induces an acceleration of: i) enzymatic activities related to the lignification, ii) esterification of phenolic acids in the cell wall. Consequently the lignification process is accelerated. Storage of the information. After being received by the target cells the information can be stored during several days before being expressed. At the level of cotyledonary bud, the first message, previously stored, can be expressed or not by a second treatment. Bidens thus behaves as if it was able to “store” and to “retrieve” morphogenetic messages, using a sort of rudimentary memory. The nuclei of the bud cells of the pricked cotyledon show that these cells, initially in G2 phase, divide and then remain in the G1 phase. In Bryonia, calli derived from young stimulated internodes, keep thigmomorphogenetic characteristics during several weeks. In the last part of this paper the particularity of our plant model which permits a study of the transmission and storage of the message, is underlined. The links between the different steps induced by the stimulus are discussed. Special attention is devoted to second messengers and to the amplification of the message. (shrink)