The lack of economic sustainability of most healthcare systems and a higher demand for quality and safety has contributed to the development of regulation as a decisive factor for modernisation, innovation and competitiveness in the health sector. The aim of this paper is to determine the importance of the principle of public accountability in healthcare regulation, stressing the fact that sunshine regulation—as a direct and transparent control over health activities—is vital for an effective regulatory activity, for (...) an appropriate supervision of the different agents, to avoid quality shading problems and for healthy competition in this sector. Methodologically, the authors depart from Kieran Walshe’s regulatory theory that foresees healthcare regulation as an instrument of performance improvement and they articulate this theory with the different regulatory strategies. The authors conclude that sunshine regulation takes on a special relevance as, by promoting publicity of the performance indicators, it contributes directly and indirectly to an overall improvement of the healthcare services, namely in countries were citizens are more critical with regard to the overall performance of the system. Indeed, sunshine regulation contributes to the achievement of high levels of transparency, which are fundamental to overcoming some of the market failures that are inevitable in the transformation of a vertical and integrated public system into a decentralised network where entrepreneurialism appears to be the predominant culture. (shrink)

In 2008 pharmaceutical companies spent over $12 billion on product promotion and detailing aimed at U.S. health care practitioners. Drug and device manufacturers rely on a workforce of detailers and physician speakers to reach health care practitioners and nudge their prescribing habits. To prevent undue influence and protect the public fisc, a number of states began regulating these marketing practices, requiring companies to disclose all gifts to practitioners, prohibiting the commercialized sale of prescription data, and prohibiting certain gifts altogether. The (...) 2010 enactment of the Physician Payment Sunshine Act marks the first Congressional involvement in the regulation of disclosure related to pharmaceutical marketing. Overall, the Act improves transparency in pharmaceutical marketing to physicians and expands the regulation of disclosure of pharmaceutical marketing activities in important substantive ways. (shrink)

Public disclosure of industry payments to physicians is one way to address financial conflicts of interest in medicine. As part of the Patient Protection and Affordable Care Act, the Physician Payment Sunshine Act requires pharmaceutical, medical device, and biologics manufacturers who have at least one product reimbursed by Medicare or Medicaid to disclose payments to physicians and teaching hospitals on a public website starting in 2014. The physician payment data will contain individual physician names, monetary values, and specific products (...) connected to payments.According to the Final Regulations issued by the Centers for Medicare and Medicaid Services in February 2013, the law will make transparent the extent and nature of relationships between physicians, teaching hospitals, and manufacturers. (shrink)

Relationships between physicians and pharmaceutical sales representatives (PSRs) often create conflicts of interest, not least because of the various benefits received by physicians. Many countries attempt to control pharmaceutical industry marketing strategies through legal regulation, and this is true in Poland where efforts are underway to eliminate any practices that might be considered corrupt in medicine. The present research considered Polish medical students’ opinions about domestic laws restricting doctors’ acceptance of expensive gifts from the industry, the idea of compulsory (...) transparency, and the possibility of introducing a Polish Sunshine Law. A qualitative, focus group-based, interview method was used. Data were gathered from nine focus groups involving 92 medical students from three universities located in major Polish cities. The article presents a classification of opposing student views with regard to the consequences of introducing different legal solutions; this should be useful for policy makers deliberating on how to optimally regulate pharmaceutical marketing. The study’s results are discussed in the context of the public bioethical debate in Poland. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:418 Feminist Studies 43, no. 2. © 2017 by the estate of tatiana de la tierra. Ode to Unsavory Lesbians i love an ugly lesbian one who walks with a limp talks with a lisp leaves her dentures out overnight by the bathroom sink wears polyester pants and men’s cologne, the cheap kind has a beard so long she steps on it sprouts warts on her toes, all twelve (...) of them carries a spittoon in her breast pocket chortles at church people i dream of a lesbian who’s always broke she doesn’t own a car, walks streets barefoot, near and far washes all her clothes by hand steals from walmart scams the business-suited man lights matches on her wooden leg barbeques freshly plucked birds on her shopping cart seasons them with salt, that’s all licks her fingers in the moonlight i crave a lesbian who’s fat and fleshy so big she can’t fit through the door at starbucks and they set up an outdoor café just for her so fat she wears bangles on her fingers her belly is a boom box her stretch marks are hieroglyphic etchings she’s so heavy, tectonic plates shift beneath her feet so huge, lake erie is her bathtub tatiana de la tierra tatiana de la tierra   419 i lust after an unsavory lesbian she blows away my lackluster day leads me in a lambada, lights lantern between my legs lays my head down on lace pillows humps me like a lamppost lacerates me with leather lust lacquers my body with blue latex paint logs the forest for prime wood builds me lakeside throne sets me there and worships me —goddess in blue— lines my path with lady slippers ravishes me with sex words pets me like a little lamb wins me by a landslide To My Kidneys i had no inkling of your existence those summers when i swam in waters at the turkey point nuclear power plant a mile from home was proud of the organic salad tomatoes and the steaming peppermint tea that came from backyard garden a block from the rex chemicals plant life at 29822 SW 147th avenue in leisure city was anything but leisurely 420 tatiana de la tierra it was all screaming and fighting and cursing hijueputa this and hijueputa that poverty pissed me off i drank too much high fructose corn syrup not enough purified water snorted cocaine smoked dope lived all toughed out while you worked silently on my behalf filtering purifying regulating i was an angry girl but i blew up no buildings killed no one i was all hot air exploding inside letting carnage settle harden at twenty-nine something was wrong the damage was done your tubules were atrophying glomeruli were dead and dying you were inflamed and irate i had twenty-four grams of protein in the urine all swollen and freakishly feverish pouring my fluids into vials and beakers tried to recollect every sun burn those little red dots on my childhood skin tatiana de la tierra   421 i was a medical mystery for months until the day doctors made a diagnosis: lupus-mediated membranous glomerulonephritis now, eighteen years later you’re all i’ve got my future is in the capillaries of your glomeruli i’ve taken pills done prayers of all kinds even injected myself with german baby’s umbilical cord to keep you going yet you falter healers put the blame on all kinds of things deep-seated fears petrochemicals lead cadmium karma white flour self-hatred seriousness we’re in this together, you and i let’s go get sunshine drink green tea grow tall and strong wade in waters up to our knees like the cypress in the florida swamps gracing riverbanks and wetlands roots filtering flowing waters branches stretching to the skies with their durable and eternal woods 422 tatiana de la tierra Topanga Canyon i had forgotten trees how they claim earth and sky a herd of elephants standing in place reaching up with their trunks carrying torches of green leaves that breathe after death crushed at my feet trees splayed out like spent lovers legs open... (shrink)

Emergency declarations are a vital legal authority that can activate funds, personnel, and material and change the legal landscape to aid in the response to a public health threat. Traditionally, declarations have been used against immediate and unforeseen threats such as hurricanes, tornadoes, wildfires, and pandemic influenza. Recently, however, states have used emergency declarations to address public health issues that have existed in communities for months and years and have risk factors such as poverty and substance misuse. Leaders in these (...) states have chosen to use emergency powers that are normally reserved for sudden catastrophes to address these enduring public health issues. This article will explore emergency declarations as a legal mechanism for response; describe recent declarations to address hepatitis A and the opioid overdose epidemic; and seek to answer the question of whether it is appropriate to use emergency powers to address public health issues that are not traditionally the basis for an emergency declaration. (shrink)

How have we come by our worldviews, and what influence did Christianity have on those that are common to Western civilization?

Cross jurisdictional collaboration efforts and emergency vaccine plans that are consistent with Tribal sovereignty are essential to public health emergency preparedness. The widespread adoption of clearly written federal, state, and local vaccine plans that address fundamental assumptions in vaccine distribution to Tribal nations is imperative for future pandemic response.

This authoritative volume provides a comprehensive road map of the important and rapidly growing field of emotion regulation.

ABSTRACTEmotion regulation substantially develops during the childhood years. This growth includes an increasing awareness that certain ER strategies are more appropriate in some contexts than...

This book develops a new naturalist theory of reason and scientific knowledge from a synthesis of philosophy and the new sciences of complex adaptive systems.

Recent theories have argued that emotions play a central role in moral decision-making and suggested that emotion regulation may be crucial in reducing emotion-linked biases. The present studies focused on the influence of emotional experience and individual differences in emotion regulation on moral choice in dilemmas that pit harming another person against social welfare. During these “harm to save” moral dilemmas, participants experienced mostly fear and sadness but also other emotions such as compassion, guilt, anger, disgust, regret and (...) contempt (Study 1). Fear and disgust were more frequently reported when participants made deontological choices, whereas regret was more frequently reported when participants made utilitarian choices. In addition, habitual reappraisal negatively predicted deontological choices, and this effect was significantly carried through emotional arousal (Study 2). Individual differences in the habitual use of other emotion regulation strategies (i.e., acceptance, rumination and catastrophising) did not influence moral choice. The results of the present studies indicate that negative emotions are commonly experienced during “harm to save” moral dilemmas, and they are associated with a deontological bias. By efficiently reducing emotional arousal, reappraisal can attenuate the emotion-linked deontological bias in moral choice. (shrink)

Although emotion regulation has traditionally been conceived as a deliberative process, there is growing evidence that many emotion-regulation processes operate at implicit levels. This special issue of Cognition and Emotion showcases recent advances in theorising and empirical research on implicit emotion regulation. Implicit emotion regulation can be broadly defined as any process that operates without the need for conscious supervision or explicit intentions, and aims at modifying the quality, intensity, or duration of an emotional response. Implicit (...) emotion regulation is likely to be pervasive in everyday life and may contribute considerably to the effectiveness of emotion regulation. Research in this area has developed several valid methods for measuring and manipulating implicit emotion. The contributions to this special issue highlight the significance of implicit emotion regulation in psychological adaptation, goal-directed behaviour, interpersonal behaviour, personality functioning, and mental health. (shrink)

Crying is a common response to emotional distress that elicits support from the environment. People may regulate another’s crying in several ways, such as by providing socio-affective support (e.g. comforting) or cognitive support (e.g. reappraisal), or by trying to emotionally disengage the other by suppression or distraction. We examined whether people adapt their interpersonal emotion regulation strategies to the situational context, by manipulating the regulatory demand of the situation in which someone is crying. Participants watched a video of a (...) crying man and provided support by recording a video message. We hypothesised that when immediate down-regulation was required (i.e. high regulatory demand), participants would provide lower levels of socio-affective and cognitive support, and instead distract the crying person or encourage them to suppress their emotions, compared to when there is no such urgency (i.e. low regulatory demand). As predicted, both self-reported and behavioural responses indicated that high (as compared to low) regulatory demand led to a reduction in socio-affective support provision, and a strong increase in suppression and distraction. Cognitive support provision, however, was unaffected by regulatory demand. When the context required more immediate down-regulation, participants thus employed more regulation strategies aimed at disengaging from the emotional experience. This study provides a first step in showing that people take the context into account when attempting to regulate others’ emotions. (shrink)

PLoS ONE 3(3): e1897. doi:10.1371/journal.pone.

This article analyzes appropriate public policies for enhancement use of two most important stimulant drugs: Ritalin (methylphenidate) and Adderall (mixed amphetamine salts). The author argues that appropriate regulation of cognition enhancement drugs cannot be a result of a general discussion on cognitive enhancements as such, but has to be made on a case-by-case basis. Starting from the recently proposed taxation approach to cognition enhancement drugs, the author analyzes available, moderately permissive models of regulation. After a thorough analysis of (...) relevant characteristics of methylphenidate and amphetamine, the author concludes that a moderately liberal permissive regulation of enhancement use by healthy adults might be appropriate for extended release forms of methylphenidate. However, due to their danger profile, amphetamine and instant release forms of methylphenidate should not be made readily available to healthy adults and would need to be prohibited. (shrink)

Because both emotional arousal and regulation are continuous, ongoing processes, it is difficult, if not impossible, to separate them. Thus, affective dynamics can reveal the regulation of emotion as it occurs in real time. One way that this can be done is through the examination of intra- and interpersonal flexibility or the transitions into and out of affective states. The present article reviews and then expands upon the Flex3 model of real-time dynamic and reactive flexibility, specifying the ways (...) in which individual differences in emotion regulation manifest as differences in flexibility. The differences in results at the real-time scale versus diurnal variability are also discussed within an emotion regulation framework. (shrink)

Children show increasing control of emotions and behavior during their early years. Our studies suggest a shift in control from the brain’s orienting network in infancy to the executive network by the age of 3—4 years. Our longitudinal study indicates that orienting influences both positive and negative affect, as measured by parent report in infancy. At 3—4 years of age, the dominant control of affect rests in a frontal brain network that involves the anterior cingulate gyrus. Connectivity of brain structures (...) also changes from infancy to toddlerhood. Early connectivity of parietal and frontal areas is important in orienting; later connectivity involves midfrontal and anterior cingulate areas related to executive attention and self-regulation. (shrink)

Systems of private regulation based on certification have recently emerged to address environmental issues in the forest products industry and labor issues in the apparel industry. To explain why the same regulatory form has emerged across these fields, the author uses a historical and comparative case study approach, closely examining early moments and paying attention to “roads not taken.” Two types of factors led to the initial emergence of private certification: social movement campaigns targeting companies and a neo-liberal institutional (...) context. The analysis shows specific ways in which these factors led states, nongovernmental organizations, and companies to build or support certification associations. (shrink)

Recent brain imaging studies using functional magnetic resonance imaging (fMRI) have implicated insula and anterior cingulate cortices in the empathic response to another’s pain. However, virtually nothing is known about the impact of the voluntary generation of compassion on this network. To investigate these questions we assessed brain activity using fMRI while novice and expert meditation practitioners generated a loving-kindness-compassion meditation state. To probe affective reactivity, we presented emotional and neutral sounds during the meditation and comparison periods. Our main hypothesis (...) was that the concern for others cultivated during this form of meditation enhances affective processing, in particular in response to sounds of distress, and that this response to emotional sounds is modulated by the degree of meditation training. The presentation of the emotional sounds was associated with increased pupil diameter and activation of limbic regions (insula and cingulate cortices) during meditation (versus rest). During meditation, activation in insula was greater during presentation of negative sounds than positive or neutral sounds in expert than it was in novice meditators. The strength of activation in insula was also associated with self-reported intensity of the meditation for both groups. These results support the role of the limbic circuitry in emotion sharing. The comparison between meditation vs. rest states between experts and novices also showed increased activation in amygdala, right temporo-parietal junction (TPJ), and right posterior superior temporal sulcus (pSTS) in response to all sounds, suggesting, greater detection of the emotional sounds, and enhanced mentation in response to emotional human vocalizations for experts than novices during meditation. Together these data indicate that the mental expertise to cultivate positive emotion alters the activation of circuitries previously linked to empathy and theory of mind in response to emotional stimuli.. (shrink)

ABSTRACTPrevious work has shown that a stooped posture may activate negative mood. Extending this work, the present experiments examine how stooped body posture influences recovery from pre-existing negative mood. In Experiment 1, participants were randomly assigned to receive either a negative or neutral mood induction, after which participants were instructed to take either a stooped, straight, or control posture while writing down their thoughts. Stooped posture led to less mood recovery in the negative mood condition, and more negative mood in (...) the neutral mood condition. Furthermore, stooped posture led to more negative thoughts overall compared to straight or control postures. In Experiment 2, all participants underwent a negative mood induction, after which half received cognitive reappraisal instructions and half received no instructions. Mood-congruent cognitions were assessed through autobiographical memory recall. Again, stooped position led to less mood recovery. Notably, this was independent of regulation instruction. These findings demonstrate for the first time that posture plays an important role in recovering from negative mood. (shrink)

When is industry self-regulation (ISR) a legitimate form of governance? In principle, ISR can serve the interests of participating companies, regulators and other stakeholders. However, in practice, empirical evidence shows that ISR schemes often under-perform, leading to criticism that such schemes are tantamount to firms marking their own homework. In response, this paper explains how current management theory on ISR has failed to separate the pragmatic legitimacy of ISR based on self-interested calculations, from moral legitimacy based on normative approval. (...) The paper traces three families of management theory on ISR and uses these to map the pragmatic and moral legitimacy of ISR schemes. It identifies tensions between the pragmatic and moral legitimacy of ISR schemes, which the current ISR literature does not address, and draws implications for the future theory and practice of ISR. (shrink)

Misinformation is a serious concern for societies across the globe. To design effective interventions to combat the belief in and spread of misinformation, we must understand which psychological processes influence susceptibility to misinformation. This paper tests the widely assumed – but largely untested – claim that emotionally provocative headlines are associated with worse ability to identify true versus false headlines. Consistent with this proposal, we found correlational evidence that overall emotional response at the headline level is associated with diminished truth (...) discernment, except for experienced anger which was associated with increased truth discernment. The second set of studies tested a popular emotion regulation intervention where people were asked to apply either emotional suppression or emotion reappraisal techniques when considering the veracity of several headlines. In contrast to the correlation results, we found no evidence that emotion regulation helped people distinguish false from true news headlines. (shrink)

The regulation of assisted reproduction technologies (ART) in China exhibits fragmentation, obsolescence, and a lower normative standing. Amid China's demographic challenges, discernible indications suggest a possible shift in stance towards the stringent regulation of ART. The present study furnishes an elucidation of extant ART regulations, delineates the developmental trajectory of reproductive rights within the Chinese legal framework, scrutinizes societal perspectives endorsing emancipated reproductive autonomy for women, and culminates by underscoring the necessity to acknowledge and uphold autonomous and substantive (...) reproductive rights throughout the process of reform. By comprehending and anticipating Chinese ART regulations, this article seeks to cultivate public discourse and enrich judicious decision-making among pertinent stakeholders. (shrink)

The article analyses the legal, economic and other problems of the legal regulation of supervision of business entities in Lithuania and outlines solutions to these problems. The first chapter describes the present situation of the legal regulation of supervision of businesses in Lithuania. The second chapter analyses the problems of the legal regulation of business supervision that the authors consider the most important. The article concludes by offering solutions to the key issues identified.

Many psychological scientists and behavioral neuroscientists affirm that “emotion” influences thinking, decision-making, actions, social relationships, well-being, and physical and mental health. Yet there is no consensus on a definition of the word “emotion,” and the present data suggest that it cannot be defined as a unitary concept. Theorists and researchers attribute quite different yet heuristic meanings to “emotion.” They show considerable agreement about emotion activation, functions, and regulation. The central goal of this article is to alert researchers, students, and (...) other consumers of “emotion” research to the multiple meanings or aspects that distinguished scientists attribute to ”emotion,” increase appreciation of its interesting and challenging complexity, and sharpen perspectives on “emotion” and the associated body of literature that is of critical significance to science and society. (shrink)

In 2018, the Chinese scientist He Jiankui presented his research at the Second International Summit on Human Genome Editing in Hong Kong. While it was intended that he facilitate a workshop, he was instead called on to present his research in heritable human genome editing, where he made the announcement that he had taken great strides in advancement of his research, to the extent that he had gene-edited human embryos and that this had resulted in the live births of two (...) children. While his research ethic and methodology was interrogated, he insisted that two children, twin girls, had been born healthy and that there was another pregnancy (at the time) where birth of a third gene edited child would be imminent. This announcement generated a ripple effect in the scientific community and exposed the gaps in regulation and absence of law relating to the technology. This resulted in a flurry of activity and conversation around regulation of the technology, which scientists stated was not ready for human trials. This article reviews the Third Summit which was held in London in March 2023 and comments on the latest developments in the regulation of heritable human genome editing. (shrink)

(2003). The Ethics and Governance of Medical Research: What does regulation have to do with morality? New Review of Bioethics: Vol. 1, No. 1, pp. 41-58.

In this paper we address the question of minimal cognition by investigating the origin of some crucial cognitive properties from the very basic organisation of biological systems. More specifically, we propose a theoretical model of how a system can distinguish between specific features of its interaction with the environment, which is a fundamental requirement for the emergence of minimal forms of cognition. We argue that the appearance of this capacity is grounded in the molecular domain, and originates from basic mechanisms (...) of biological regulation. In doing so, our aim is to provide a theoretical account that can also work as a possible conceptual bridge between Synthetic Biology and Artificial Intelligence. In fact, we argue, Synthetic Biology can contribute to the study of minimal cognition, by providing a privileged approach to the study of these mechanisms by means of artificial systems. (shrink)

What are ethics? -- News : towards a definition -- Morality of reporting -- The good journalist -- Truth, accuracy, objectivity and trust -- Privacy and intrusion -- Reputation -- Gathering the news -- Reporting the vulnerable -- Deciding what to publish -- Taste and decency : harm and offence -- Professional practice -- Regulation -- History of print regulation -- History of broadcast regulation -- Codes of conduct as a regulatory system -- Press regulation systems (...) in the UK and Ireland -- Broadcast regulation systems in the UK and Ireland -- The experience abroad. (shrink)

The global industry engaged in direct-to-consumer marketing of unproven stem cell-based interventions has undergone sweeping changes over the past decade. Two of the most striking developments in recent years have been the emergence of stem cell marketing businesses in highly developed nations, such as the United States, Japan, and Australia, and the industry's convergence on a much narrower range of supposedly therapeutic cell types than in the past. The greatest number of businesses advertising unproven uses of stem cells in English (...) are now in the US, and the majority of those promote unproven therapeutic uses of autologous cells (see Supplementary Table S1 in Turner and... (shrink)

Moral judgment has typically been characterized as a conflict between emotion and reason. In recent years, a central concern has been determining which process is the chief contributor to moral behavior. While classic moral theorists claimed that moral evaluations stem from consciously controlled cognitive processes, recent research indicates that affective processes may be driving moral behavior. Here, we propose a new way of thinking about emotion within the context of moral judgment, one in which affect is generated and transformed by (...) both automatic and controlled processes, and moral evaluations are shifted accordingly. We begin with a review of how existing theories in psychology and neuroscience address the interaction between emotion and cognition, and how these theories may inform the study of moral judgment. We then describe how brain regions involved in both affective processing and moral judgment overlap and may make distinct contributions to the moral evaluation process. Finally, we discuss how this way of thinking about emotion can be reconciled with current theories in moral psychology before mapping out future directions in the study of moral behavior. (shrink)

The development of self-regulation in early childhood is related to development of emotional regulation and attention, in particular executive attention. As the ability to self-regulate is crucial in life, it is important to reveal early predictors of self-regulation. The aim of the paper is to present the results of longitudinal studies on the relationships between the functioning of attention, regulation of emotion and later self-regulatory abilities. 310 children were assessed at three time points. At 12 months (...) of age emotional regulation in situation of frustration and attention regulation were assessed. At 18 and 24 months behavioral-emotional regulation in the Snack Delay Task was measured. Additionally parents assessed executive attention using The Early Childhood Behavior Questionnaire when children were 26 months old. Structural equation modelling revealed two different paths to development of self-regulatory abilities at 18 months: emotional and emotionalattentional and only one emotional-attentional path at 24 months. The early ability to focus attention and later executive attention functioning revealed to be important predictors of self-regulatory abilities both at 18 and 24 months of age. (shrink)

Some 41 million Americans, many of them children, currently live below the official poverty level. As a proportion of the population, the number has been stable for several decades. But what it mea...

This article proposes a novel mapping of the complex relationship between business ethics and regulation, by suggesting five distinct ways in which business ethics and regulation may intersect. The framework is applied to a comparative case study of business responses to climate change regulation in Canada and Germany, both signatories to the Kyoto Protocol. Both countries represent distinctly different approaches which yield significant lessons for emerging economies. We also analyze the specific role of large multinational corporations in (...) this process. (shrink)

On occasion, British in vitro fertilization practitioners look over the ocean to the practice of IVF and embryo research in the United States, wonder why these areas are subject to less regulation than in the United Kingdom, and ask how much less risky and more progressive IVF and embryo research might be if subject to additional federal, or at least state, regulation. To an American audience, imbued with the centuries‐old spirit of independence, regulation and autonomy can seem (...) in tension. From a British perspective, there is no necessary conflict. There is no dissent in the United Kingdom from the proposition that individual activities, services, and industries can be regulated and, at the same time, retain and exercise such autonomy as is their right within a safe sphere. From 1994 to 2002, I was the chair of the United Kingdom's Human Fertilisation and Embryology Authority, which regulates the practice of IVF and embryo research. The existence of the HFEA assures patients that safety and aspects of the practice of assisted reproduction are monitored, leaving them free to choose without worrying about danger, in the same way that the public may take only those drugs that have passed health and safety tests. I would propose that anxious and vulnerable patients do not have more autonomy in a less regulated, market‐driven field. (shrink)