Nurses have moral obligations incurred by membership in the profession to participate knowingly in health policy advocacy. Many barriers have historically hindered nurses from realizing their potential to advance health policy. The contemporary political context sets additional challenges to policy work due to polarization and conflict. Nursing education can help nurses recognize their role in advancing health through political advocacy in a manner that is consistent with disciplinary knowledge and ethical responsibilities. In this paper, the authors describe an exemplar of (...) Elizabeth Barrett's “Power as Knowing Participation in Change” theory as a disciplinary lens within a doctoral nursing health policy course. Barrett (radically) emphasizes “power as freedom” instead of “power as control.” This approach is congruent with nursing disciplinary values and enhances awareness of personal freedom and building collaborative relationships in the policy process. The theory was used in concert with other traditional policy content and frameworks from nursing and other disciplines. We discuss the role of nursing ethics viewed as professional responsibility for policy action, an overview of Barrett's theory, and the design of the course. Four student reflections on how the course influenced their thinking about policy advocacy are included. While not specific to policymaking, Barrett's theory provides a disciplinary grounding to increase students' awareness of freedom and choices in political advocacy participation. Our experience suggests that Barrett's work can be fruitful for enhancing nurses' awareness of choices to participate in change across settings. (shrink)

The present debate over the creation and potential deployment of lethal autonomous weapons, or ‘killer robots’, is garnering more and more attention. Much of the argument revolves around whether such machines would be able to uphold the principle of noncombatant immunity. However, much of the present debate fails to take into consideration the practical realties of contemporary armed conflict, particularly generating military objectives and the adherence to a targeting process. This paper argues that we must look to the targeting process (...) if we are to gain a fuller picture of the consequences of creating or fielding lethal autonomous robots. This paper argues that once we look to how militaries actually create military objectives, and thus identify potential targets, we face an additional problem: the Strategic Robot Problem. The ability to create targeting lists using military doctrine and targeting processes is inherently strategic, and handing this capability over to a machine undermines existing comman.. (shrink)

ABSTRACTAutonomous weapons systems pose many challenges in complex battlefield environments. Previous discussions of them have largely focused on technological or policy issues. In contrast, we focus here on the challenge of trust in an AWS. One type of human trust depends only on judgments about the predictability or reliability of the trustee, and so are suitable for all manner of artifacts. However, AWSs that are worthy of the descriptor “autonomous” will not exhibit the required strong predictability in the complex, changing (...) contexts of war. Instead, warfighters need to develop deeper, interpersonal trust that is grounded in understanding the values, beliefs, and dispositions of the AWS. Current acquisition, training, and deployment processes preclude the development of such trust, and so there are currently no routes for a warfighter to develop trust in an AWS. We thus survey three possible changes to current practices in order to facilitate the type of deep trust that is required for appropri... (shrink)

This paper provides an overview of the societal impact of a rising dementia population and examines the legal and ethical implications posed by voluntary registries as a community-oriented solution to improve interactions between law enforcement and individuals with dementia. It provides a survey of active voluntary registries across the United States, with a focus on Arizona, which has the highest projected growth for individuals living with dementia in the country.

This article explores how US legal expansions narrow justice possibilities. Drawing from Joan Scott's work on experience, echo and reverberation, the article puts forth a method for reading the convergence of historical absences within legal subjectivity. In particular, it traces the denial of one Nigerian woman's US political asylum claim within the context of US handlings of Nigerian human rights cases focused on petroleum violence alongside the expansion of political asylum to include gender and sexual violence. The article accounts for (...) the production of gender within a larger context of colonial state violence and questions how gender becomes a viable legal category through a variety of violent histories that implicate the US. By reframing questions of feminist justice within the site of law, the article argues for a deeper engagement with discontinuous narratives, which read against our common sense understandings, as a first step in divesting in US legal privilege. (shrink)

© 2014 Shapiro, Tassone, Choudhary and Simon.Chromosome 22q11.2 Deletion Syndrome is caused by the most common human microdeletion, and it is associated with cognitive impairments across many domains. While impairments in cognitive control have been described in children with 22q11.2DS, the nature and development of these impairments are not clear. Children with 22q11.2DS and typically developing children were tested on four well-validated tasks aimed at measuring specific foundational components of cognitive control: response inhibition, cognitive flexibility, and working memory. Molecular assays (...) were also conducted in order to examine genotype of catechol-O-methyltransferase, a gene located within the deleted region in 22q11.2DS and hypothesized to play a role in cognitive control. Mixed model regression analyses were used to examine group differences, as well as age-related effects on cognitive control component processes in a cross-sectional analysis. Regression models with COMT genotype were also conducted in order to examine potential effects of the different variants of the gene. Response inhibition, cognitive flexibility, and working memory were impaired in children with 22q11.2DS relative to TD children, even after accounting for global intellectual functioning. When compared with TD individuals, children with 22q11.2DS demonstrated atypical age-related patterns of response inhibition and cognitive flexibility. Both groups demonstrated typical age-related associations with working memory. The results of this cross-sectional analysis suggest a specific aberration in the development of systems mediating response inhibition in a sub-set of children with 22q11.2DS. It will be important to follow up with longitudinal analyses to directly examine these developmental trajectories, and correlate neurocognitive variables with clinical and adaptive outcome measures. (shrink)

Understanding risk factors for relationship dissolution and poor relationship adjustment among couples has been an active area of research in relationship science. One risk factor, non-marital cohabitation, has shown to predict higher rates of relationship dissolution and relationship instability in some samples, but the associations among German parents with children over time are less clear. In this study, we examined the links between non-marital cohabitation and 10-year outcomes in 220 German families with preschool-aged children at the initial assessment followed into (...) adolescence. Families were assessed 7 times over the 10 years and retention at the 10-year follow-up was over 92%. After accounting for multiple testing, only mother’s report of better initial interparental communication predicted whether parents were likely to stay together over the course of the 10 years. Adolescents of parents who cohabited were at higher risk for externalizing symptoms 10 years later compared to children of married parents. In addition, although there were no differences between cohabiting couples and married couples at the initial assessment in relationship adjustment, cohabiting mothers who stayed with their partner over the 10 years showed significantly greater declines in relationship adjustment over the 10 years compared to married mothers. Findings indicate the need for further research that explores family structure and dynamics over time to inform refinement of prevention programs targeting relationships and children’s mental health. (shrink)

The recent deluge of sexual harassment allegations in the media serves as a reminder that sexual harassment remains a pervasive, destructive occurrence in the workplace. Organizations in the United States have taken a legal‐centric approach to managing workplace sexual harassment, resulting in impotent anti‐harassment policies, ineffective sexual harassment training, and underused reporting mechanisms. In this conceptual paper, I argue that men's differential perceptions of sociosexual behaviors have propagated this legal‐centric approach, which fails to meet organizations’ ethical obligation to provide a (...) safe and healthy work environment. Specifically, men have a different psychological experience of sexual harassment, which may inhibit their ability to take the perspective of targets. This lack of perspective‐taking has influenced the jurisprudence on workplace sexual harassment, which has in turn informed organizations’ approach to managing the phenomenon. I contribute to research on both business ethics and workplace sexual harassment by integrating two bodies of scholarship that have developed largely independent of one another: organizational psychology and legal. In so doing, I offer an explanation for the continued pervasiveness of workplace sexual harassment despite decades of legal sanction, organizational interventions, and research. (shrink)

While research has consistently found that general distress and psychopathology are not predictive of sexual recidivism, examination of specific syndromes and their relationship to offending has revealed a potentially more complicated relationship. One proposed mechanism for the mixed findings with respect to major mental illness and sexual offending may be the confound of neurological injury. As identified in Mann et al. work on psychologically meaningful risk factors, mental illness represents an area in need of more study given the indirect influence (...) it may exert on risk. To this end, the current paper summarizes the study of the relationship between neurological injury, psychosis and problematic sexual behavior among two Canadian samples of forensic and civil psychiatric patients. In the first study we observed higher than expected rates of sexually-themed psychotic symptoms and problematic sexual behavior among a combined group of forensic and civil psychiatric patients. Indeed 70 percent of those individuals who engaged in PSB endorsed sexually-themed psychotic symptoms. While comorbidity is common amongst this group, brain injury appeared to represent a specific liability. Compared to those who did not engage in PSB, those who did were almost 4x more likely to have a documented history of brain injury. In the second study we sought to replicate this finding in a larger forensic sample of 1,240. However, the recorded rates of brain injury were significantly less, such that no relationship to PSB was observed. Based on the mixed findings to date, including our own data, questions remain about the nature of a potential shared vulnerability for psychosis and PSB previously postulated. Among psychiatrically complex individuals who engage in PSB, understanding etiology and links to risk are helpful, but perhaps more importantly is attention to the mechanisms through which symptoms confer risk and how best to treat and manage them. (shrink)

Kant claimed that human beings have no duties to animals because they are not autonomous ends in themselves. I argue that Kant was wrong to exclude animals from the realm of moral consideration. Animals, although they do not set their own ends and thus cannot be regarded as ends in themselves, do have ends that are given to them by nature. As beings with ends, they stand between mere things that have no ends, and rational beings that are ends in (...) themselves. I propose a broader version of Kant's kingdom of ends, in which rational beings respect the ends of all other beings that have them, including animals. The moral status of animals would still be dependent on the existence of rational beings, but our duty to take their ends into account would be a direct duty to them, rather than being a covert duty to human beings. (shrink)

ObjectivesDuring their lifetimes, a majority of musicians experience playing-related musculoskeletal disorders. PRMD prevalence is tied to instrument choice, yet most studies examine heterogeneous groups of musicians, leaving some high-risk groups such as oboists understudied. This paper aims to ascertain the prevalence and nature of PRMDs in oboists, determine relevant risk factors, and evaluate the efficacy of treatment methods in preventing and remedying injuries in oboe players.MethodsA 10-question online questionnaire on PRMDs and their treatments was completed by 223 oboists. PRMDs were (...) compared across gender, weekly playing hours, career level, age, and years of playing experience.ResultsOf all respondents, 74.9% reported having had at least one PRMD in their lifetime. A majority of these injuries were of moderate to extreme severity. Females reported significantly more severe injuries than males. No significant effects of career level, age, or years of playing experience were observed. We found significant non-linear relationships between weekly playing hours and PRMD prevalence and severity. Injuries were most commonly on the right side of the body, with the right thumb, wrist, hand, and forearm being most affected in frequency and severity. Of those injuries for which recovery information was provided, only 26.1% of injuries were “completely recovered.” The perceived effectiveness of a few treatments tended to be ranked more highly than others.ConclusionThe oboists in this study experienced high rates of PRMD, particularly in the right upper extremities. Females and those playing 7-9 and 16-18 h per week reported a significantly higher severity of injuries than other groups. (shrink)

Tomasello argues that humans’ sense of moral obligation emerges early in development, relies on a shared “we,” and serves as the foundation of cooperation. This perspective complements our theoretical view of the human self as information agent. The shared “we” promotes not only proximal cooperative goals but also distal ones via the construction of shared understanding – it promotes culture.

The passage of the UN Protocol to Prevent, Suppress, and Punish Trafficking in Persons, Especially Women and Children in 2000 marked the first global effort to address human trafficking in 50 years. Since the passage of the UN Protocol international organizations, non-governmental organizations, and individual states have devoted significant resources to eliminating human trafficking. This article critically examines the impact of these efforts with reference to the trends, political, and empirical challenges in data collection and the limitations of international law. (...) I argue that current international law disproportionately addresses the criminal prosecution of traffickers at the expense of trafficking victims’ human rights, and has therefore not yet reached its full potential in the fight against human sex trafficking. (shrink)

The intersection of ethics, religion, theology, and peace studies is intensifying through increasingly multi‐disciplinary, contextual, explicitly normative scholarship. This book discussion demonstrates this claim through its profiles of an introduction to Christian ethics by Ellen Ott Marshall, a case study of the School of the Americas Watch by Kyle B. T. Lambelet, a case study of the American Jewish Palestine solidarity movement by Atalia Omer, and a global, historical study of Christian ethics by Cecilia Lynch. Though their methods and subjects (...) vary, these authors are collectively renewing a history of mutual enrichment between religious ethics and peace studies, employing theories of lived, ambivalent religion. To begin, this essay provides introductory remarks about the field of peace studies, highlighting the evolving involvement of religious actors. To conclude, it makes a plea for greater use of conflict theory and peace practice in religious ethics. (shrink)

Few historical subjects have generated such intense and sustained interest in recent decades as Britain's imperial past. What accounts for this preoccupation? Why has it gained such purchase on the historical imagination? How has it endured even as its subject slips further into the past?In seeking to answer these questions, the proposed volume brings together some of the leading figures in the field, historians of different generations, different nationalities, different methodological and theoretical perspectives and different ideological persuasions. Each addresses the (...) relationship between their personal development as historians of empire and the larger forces and events that helped to shape their careers. The result is a book that investigates the connections between the past and the present, the private and the public, the professional practices of historians and the political environments within which they take shape. This intellectual genealogy of the recent historiography of empire will be of great value to anyone studying or researching in the field of imperial history. (shrink)

Judges are typically tasked to consider sentencing benefits but not costs. Previous research finds that both laypeople and prosecutors discount the costs of incarceration when forming sentencing attitudes, raising important questions about whether professional judges show the same bias during sentencing. To test this, we used a vignette-based experiment in which Minnesota state judges reviewed a case summary about an aggravated robbery and imposed a hypothetical sentence. Using random assignment, half the participants received additional information about plausible negative consequences of (...) incarceration. As predicted, our results revealed a mitigating effect of cost exposure on prison sentence term lengths. Critically, these findings support the conclusion that policies that increase transparency in sentencing costs could reduce sentence lengths, which has important economic and social ramifications. (shrink)

Mayer, Caruso, and Salovey provide useful updates to the EI ability model and related concepts. However, they do not acknowledge conceptual limitations with the MSCEIT proportion scoring algorithm. In our view, failure to recognize these limitations has impeded refinements to the EI ability model and delayed support for positioning EI within the Cattell-Horn-Carroll three-stratum theory of intelligence. Fully appreciating algorithm-related issues justifies the reanalysis of MSCEIT data and may expand the range of metrics that are available to refine EI theory.

The goals of vascular composite allotransplantation for hand are to maximize functional status and psychosocial wellbeing and to improve quality of life. Candidates are carefully vetted by transplant programs through an extensive evaluation process to exclude those patients with contraindications and to select those that are most likely to attain functional or quality of life benefit from transplant. Patient choice for any treatment, however, requires that candidates be able to understand the risks, benefits, and alternatives before choosing to proceed. This (...) study aimed to understand patients’ knowledge and perceptions about treatment options for hand loss, including hand transplant. This study will be used to inform a standardized education approach and develop conversation aids for use by clinicians and patients throughout the treatment decision process. Ten individuals who had experienced hand amputation or had congenital limb loss were interviewed to better understand previous and current decisions about treatment, experiences in adjusting to their treatment, and perceptions about hand VCA. From this qualitative interview data, four findings emerged: knowledge and education around VCA as a treatment option; adaptation of individuals with limb loss; fear of risk associated with transplantation; issues of aging and overuse injuries to existing limbs. Results suggests that there is opportunity for expanding education about all treatment options for patients with new loss, long-term loss, and congenital limb loss. Establishing a baseline of knowledge about all options–prosthetics, rehabilitative strategies, and VCA—can help patients evaluate their values and goals of treatment. Issues associated with aging, including overuse and injury, and adaptability over the life course should be included in considerations about treatment choices. Data indicate the need for routinely assessing patient preferences about treatment choice so patients can plan for their future as they adapt and age and as technology for treatments change. To assure that thorough information is provided for current and future decision-making, education about treatment choices and selection procedures for VCA should be standardized. (shrink)

Reconstructive allografts using Vascularized Composite Allotransplantation are providing individuals living with upper limb loss and facial disfigurement with new opportunities for a sensate, esthetically acceptable, and functional alternative to current treatment strategies. Important research attention is being paid to how best to assess and screen candidates for VCA, measure optimal patient outcomes, and support patient adherence to lifelong behaviors and medical regimens. Far less attention, however, has been dedicated to the team science required for these complex VCA teams to form, (...) prepare, and provide the highest quality clinical and psychosocial care to those receiving VCA. VCA teams are unique in that they require specialized team members whose scope of practice may not otherwise overlap. The team also needs to constantly negotiate balancing patient safety with multiple risks throughout the transplant process. This study aimed to elucidate the team science needed for this highly innovative and complex area of medicine. Using in-depth qualitative interviews with 14 VCA team members and observations at team meetings, we found that careful consideration of team composition, team structure, and organizational commitment influences team performance and patient outcomes, but that to be efficient and truly effective, teams need to commit to developing processes that foster collaboration. These processes are action-oriented, strategic and interpersonal. Dedication and commitment to team science allows teams to manage conflict under stress and exercise ways to leverage strengths to provide optimal performance or patient psychosocial and clinical outcomes. This study can provide insight into quality improvement efforts for VCA teams and guidance for other transplant programs that wish to consider expansion into VCA. (shrink)

Strangers to Nature brings together many of the leading scholars who are working to redefine and expand the discourse on animal ethics. This volume will engage both scholars and lay-people by revealing the breadth of theorizing about the human/non-human animal relationship that is currently taking place.

Hundreds of thousands of individuals experience traumatic injuries each year. Some are mild to moderate in nature and patients experience full functional recovery and little change to their physical appearance. Others result in enduring, if not permanent, changes in physical functioning and appearance. Reconstructive plastic surgical procedures are viable treatments options for many patients who have experienced the spectrum of traumatic injuries. The goal of these procedures is to restore physical functioning and reduce the psychosocial burden of living with an (...) appearance that may be viewed negatively by the patient or by others. Even after receipt of reconstructive procedures, many patients are left with residual disfigurement. In some, disability and disfigurement may be so profound that individuals are candidates for vascularized composite allotransplantation procedures, i.e., the transplantation of a vascularized human body part containing multiple tissue types as an anatomical and/or structural unit. This narrative review paper summarizes the literature on the psychosocial burden experienced by those who have visible disfigurement. While many of these individuals experience stigma and discrimination, relatively few studies have employed a stigma framework to understand the psychosocial sequelea. This paper briefly addresses this framework. Last, particular focus is given to the psychosocial issues of individuals with particularly severe injuries who are potential candidates for VCA procedures. (shrink)

BackgroundSelf-prescribing and prescribing to personal contacts is explicitly discouraged by General Medical Council guidelines.AimsThis study examines how widespread the practice of self-prescribing and prescribing to personal contacts is.MethodsA 16-item questionnaire was distributed via an online forum comprising 4445 young medical doctors, which asked respondents about previous prescribing to themselves, their families, friends and colleagues, including the class of medication prescribed. Demographic details were collected including medical grade and specialty.ResultsA total of 729 responses were obtained, the majority of which were from (...) young non-consultant hospital doctors from a range of specialties. Two-thirds of respondents had self-prescribed, over 70% had prescribed to family, and nearly 60% had prescribed to a friend or colleague. Older doctors were more likely to self-prescribe. Interns being less likely to self-prescribe was not unexpected, while general practitioners and paediatricians were more likely to self-prescribe. GPs, paediatricians and hospital medicine specialties were more likely to prescribe to family and surgeons were more likely to prescribe to friends. Some 3% to 7% who had self-prescribed had prescribed an opiate, benzodiazepine or psychotropic medication. Male doctors, anaesthetists and surgeons were more likely to self-prescribe opioids, while those in hospital medicine were more likely to self-prescribe psychotropic medications.ConclusionPrescribing outside the traditional doctor-patient relationship is widespread despite clear professional guidance advising against it. (shrink)

Genomic research projects that collect tissues from deceased organ and tissue donors must obtain the authorization of family decision makers under difficult circumstances that may affect the authorization process. Using a quasi-experimental design, the Ethical, Legal, and Social Issues (ELSI) substudy of the Genotype-Tissue Expression (GTEx) project compared the recall and understanding of the donation authorization process of two groups: family members who had authorized donation of tissues to the GTEx project (the comparison group) and family members who had authorized (...) organ and tissue donations in years previous, who subsequently participated in two different mock-authorization processes that mimicked the GTEx authorization process (the intervention groups). Participants in the comparison and intervention groups were matched on key demographic characteristics.We found that participants in the intervention groups who experienced a mock-authorization process demonstrated better recall of the tissue donation request than members of the comparison group. Our data indicate that the stress associated with the loss of a loved one limited the ability of family members to recall details about the GTEx project. However, we found a similar lack of knowledge in both the comparison and the intervention group participants, suggesting lack of knowledge may be due to the complexity and unfamiliarity of the information presented to them during the authorization process. We discuss these findings in the context of everyday clinical decision making in cognitively challenging conditions. (shrink)