This review emphasizes the worldwide and U.S. evolving population demographics and the need for the dental profession to exercise its professional and ethical duty to expand its traditional patient base to provide needed services.

Following the research of Liedtka (1989), this paper examines the impact of her values congruence model on managers'' work attitudes and perceptions of ethical practices within their firms. A nationwide cross-section of managers (N=1,059) provides the sample for the study. Consonance or clarity about both personal value systems and organizational value systems were found to be more important and, in the absence of one or the other, clarity of personal values were shown to have a more positive impact than organizational (...) value clarity. (shrink)

The value of any kind of data is greatly enhanced when it exists in a form that allows it to be integrated with other data. One approach to integration is through the annotation of multiple bodies of data using common controlled vocabularies or ‘ontologies’. Unfortunately, the very success of this approach has led to a proliferation of ontologies which itself creates obstacles to integration. The Open Biomedical Ontologies (OBO) consortium has set in train a strategy to overcome this problem. Existing (...) OBO ontologies, including the Gene Ontology, are undergoing a process of coordinated reform and new ontologies being created on the basis of an evolving set of shared principles governing ontology development. The result is an expanding family of ontologies designed to be interoperable, logically well-formed, and to incorporate accurate representations of biological reality. We describe the OBO Foundry initiative, and provide guidelines for those who might wish to become involved. (shrink)

This study investigated several issues with 1498 managers nationwide regarding, for example, how ethical they felt their organizations were and whether their personal principles must be compromised for the organization's sake. In addition their decision criteria for two scenarios involving ethical implications were articulated.

By constructing a maximal incomplete d.r.e. degree, the nondensity of the partial order of the d.r.e. degrees is established. An easy modification yields the nondensity of the n-r.e. degrees and of the ω-r.e. degrees.

Objectives“Attachment difficulties” is an umbrella term often used to describe various forms of non-secure attachment. Differentiating “attachment difficulties” from autism spectrum disorder and attention deficit hyperactivity disorder has been characterized as challenging. Few studies have explored how this happens in practice, from the perspective of professionals.DesignQualitative study.MethodsWe conducted in-depth semi-structured interviews with healthcare professionals from five NHS Foundation Trusts in the United Kingdom. Participants were recruited using a combination of snowballing, convenience and purposive sampling. Data were analyzed using a thematic (...) approach.ResultsWe identified six interrelated themes that might reflect difficulties with differential conceptualization. These include: a clinical lexicon of attachment; approaching attachment with caution; contextual factors; perceived characteristic behaviors; assessing attachment and adjacent supports; spotlighting intervention and dual conceptualization.ConclusionOur results indicate some of the ways suspicions around attachment are raised in practice. We advocate for more dialogue between research and practice communities on issues of differential conceptualization. We call for collaboration between a panel of experts consisting of attachment and neurodevelopmental orientated practitioners and researchers, to clarify issues around differentiating between attachment difficulties, ASD, and ADHD. (shrink)

This commentary focuses on the importance of auditory object processing for producing and comprehending human language, the relative lack of development of this capability in nonhuman primates, and the consequent need for hominid neurobiological evolution to enhance this capability in making the transition from protosign to protospeech to language.

Many existing biomedical vocabulary standards rest on incomplete, inconsistent or confused accounts of basic terms pertaining to diseases, diagnoses, and clinical phenotypes. Here we outline what we believe to be a logically and biologically coherent framework for the representation of such entities and of the relations between them. We defend a view of disease as involving in every case some physical basis within the organism that bears a disposition toward the execution of pathological processes. We present our view in the (...) form of a list of terms and definitions designed to provide a consistent starting point for the representation of both disease and diagnosis in information systems in the future. (shrink)

ABSTRACTDifficulties with inhibiting fear have been associated with the emergence of anxiety problems and poor response to cognitive–behavioural treatment. Fear inhibition problems measured using experimental paradigms involving aversive stimuli may be inappropriate for vulnerable samples and may not capture fear inhibition problems evident in everyday life. We present the Fear Inhibition Questionnaire, a self-report measure of fear inhibition abilities. We assess the FIQ’s factor structure across two cultures and how well it correlates with fear inhibition indices derived experimentally. Adolescent participants (...) from Hong Kong and England completed the FIQ, with the English participants also completing a conditioning and extinction task to assess fear inhibition problems. Across both cultures, the FIQ showed a single factor structure and low FIQ scores, or worse fear inhibition problems, were associated with self-reports of heightened anxiety. Correlation of FIQ scores with experimental indices, whi... (shrink)

The significance of teaching to the evolution of human culture is under debate. We contribute to the discussion by using a quantitative, cross-cultural comparative approach to investigate the role of teaching in the lives of children in two small-scale societies: Aka foragers and Ngandu farmers of the Central African Republic. Focal follows with behavior coding were used to record social learning experiences of children aged 4 to 16 during daily life. “Teaching” was coded based on a functional definition from evolutionary (...) biology. Frequencies, contexts, and subtypes of teaching as well as the identity of teachers were analyzed. Teaching was rare compared to observational learning, although both forms of social learning were negatively correlated with age. Children received teaching from a variety of individuals, and they also engaged in teaching. Several teaching types were observed, including instruction, negative feedback, and commands. Statistical differences in the distribution of teaching types and the identity of teachers corresponded with contrasting forager vs. farmer foundational cultural schema. For example, Aka children received less instruction, which empirically limits autonomous learning, and were as likely to receive instruction and negative feedback from other children as they were from adults. Commands, however, exhibited a different pattern suggesting a more complex role for this teaching type. Although consistent with claims that teaching is relatively rare in small-scale societies, this evidence supports the conclusion that teaching is a universal, early emerging cognitive ability in humans. However, culture structures the nature of teaching. (shrink)

Most of what we know about teaching comes from research among people living in large, politically and economically stratified societies with formal education systems and highly specialized roles with a global market economy. In this paper, we review and synthesize research on teaching among contemporary hunter-gatherer societies. The hunter-gatherer lifeway is the oldest humanity has known and is more representative of the circumstances under which teaching evolved and was utilized most often throughout human history. Research among contemporary hunter-gatherers also illustrates (...) a complex pattern of teaching that is both consistent with and distinct from teaching in other small- and large-scale societies with different subsistence practices and cultural forms. In particular, we find that the cultural emphasis on individual autonomy and socio-political egalitarianism among hunter-gatherers differently shapes how teaching occurs. For example, teaching clearly exists among hunter-gatherers and appears in many forms, including institutionalized instruction in valued cultural and technical skills. However, teaching tends to be less common in hunter-gatherer societies because people live in small, intimate egalitarian, groups that support each other’s learning in a variety of ways without teaching. Furthermore, foundational cultural schemas of autonomy and egalitarianism impact the nature of teaching. For example, adults and older children limit their interventions, permitting autonomous learning, and, when they occur, teaching episodes are generally brief, subtle, indirect, and situated in a present activity. We discuss the implications of this research in terms of discussions of the evolution of human cognition and the co-evolution of teaching and culture through the process of cultural niche construction. (shrink)

We conducted focus groups with 47 potential jurors who were presented with diferent scenarios in a hypothetical malpractice case involving failure to order a PSA test. Better documentation that a patient made an informed decision to decline a PSA test appeared to provide more medical-legal protection for physicians, especially with the use of a decision aid.

Screening for prostate cancer with the prostate-specific antigen blood test is controversial, as evidence to date has not demonstrated such screening does more good than harm. While the potential benefit of PSA screening on reducing prostate cancer mortality has not been documented in randomized trials, many risks of PSA screening have been well documented. These risks include a substantially higher risk of a prostate cancer diagnosis over a screenee’s lifetime, false-positive and false-negative test results, possible complications from biopsies done in (...) response to suspicious test results, and substantial risks of side effects from subsequent prostate cancer treatments. Nevertheless, PSA screening is widespread in the United States, and many physicians in a national survey reported supporting routine PSA screening as well as getting PSA tests themselves, despite the lack of evidence. (shrink)

Book reviewed in this article: Public Duties: The Moral Obligations of Government Officials. Edited by Joel L. Fleishman, Lance Liebman, and Mark H. Moore.

The current informal practice of pharmacometrics as a combination art and science makes it hard to appreciate the role that informatics can and should play in the future of the discipline and to comprehend the gaps that exist because of its absence. The development of pharmacometric informatics has important implications for expediting decision making and for improving the reliability of decisions made in model-based development. We argue that well-defined informatics for pharmacometrics can lead to much needed improvements in the efficiency, (...) effectiveness, and reliability of the pharmacometrics process. The purpose of this paper is to provide a description of the pervasive yet often poorly appreciated role of informatics in improving the process of data assembly, a critical task in the delivery of pharmacometric analysis results. First, we provide a brief description of the pharmacometric analysis process. Second, we describe the business processes required to create analysis-ready data sets for the pharmacometrician. Third, we describe selected informatic elements required to support the pharmacometrics and data assembly processes. Finally, we offer specific suggestions for performing a systematic analysis of existing challenges as an approach to defi ning the next generation of pharmacometric informatics. (shrink)

The objective of this study is to evaluate if use of a patient decision aid, when choosing between a repeat cesarean or a trial of labor after a cesarean, reduces medical liability exposure. The authors conclude that use of a PDA conferred liability protection when potential jurors were presented with a hypothetical malpractice claim against an obstetrician following a TOLAC.