IntroductionHead and neck cancer diagnosis and treatment can be a significant life trauma. Some HNC survivors experience post-traumatic growth, which has been linked with better health-related quality-of-life. Empirical research on PTG, and theoretical models, point to the importance of being able to purposely make sense of the traumatic experience. Intrusive rumination, by contrast, is linked to poorer outcomes. This study explored HNC survivors’ experiences of rumination.MethodsTwenty HNC survivors between 9 months and 5 years post-diagnosis were recruited. They had a range (...) of HNC sub-types and cancer treatments. Participants underwent a semi-structured interview about their cancer diagnosis and treatment. Reflexive thematic analysis identified themes and sub-themes around rumination.ResultsFour themes with linked subthemes on the content and process of rumination were identified. Theme 1 was rumination and worry related to diagnosis. Here, survivors discussed how the HNC diagnosis and plans for treatment had dominated their initial thoughts. Theme 2 was processing the trauma of HNC. This theme reflected rumination on the traumatic experience of diagnosis and treatment and how the participant was reacting to it. Theme 3 was considering the impact. This theme encompassed retrospective thinking and comparisons between the participant now versus the early days after diagnosis. Theme 4 was continued rumination. This theme included ongoing intrusive and distressing rumination about the trauma and impact of cancer. Those who expressed ongoing rumination revisited fears or returned to negative experiences.ConclusionThis study uniquely describes the nature and content of rumination following HNC. Early intrusive rumination is common and may reflect perceptions of cancer as an existential threat. Over time, rumination can become more reflective and move towards deliberate meaning-making. Some HNC survivors may benefit from interventions to reduce barriers to this transition. The content of distressing and difficult to control rumination helps to identify those who may benefit from more directed psychological support. (shrink)

The first years of life mark a time of rapid development and dietary change, as children transition from an exclusive milk diet to a modified adult diet. During these early years, children's learning about food and eating plays a central role in shaping subsequent food choices, diet quality, and weight status. Parents play a powerful role in children's eating behavior, providing both genes and environment for children. For example, they influence children's developing preferences and eating behaviors by making some foods (...) available rather than others, and by acting as models of eating behavior. In addition, parents use feeding practices, which have evolved over thousands of years, to promote patterns of food intake necessary for children's growth and health. However in current eating environments, characterized by too much inexpensive palatable, energy dense food, these traditional feeding practices can promote overeating and weight gain. To meet the challenge of promoting healthy weight in children in the current eating environment, parents need guidance regarding alternatives to traditional feeding practices. (shrink)

Eating behaviors evolve during the first years of life as biological and behavioral processes directed towards meeting requirements for health and growth. For the vast majority of human history, food scarcity has constituted a major threat to survival, and human eating behavior and child feeding practices have evolved in response to this threat. Because infants are born into a wide variety of cultures and cuisines, they come equipped as young omnivores with a set of behavioral predispositions that allow them to (...) learn to accept the foods made available to them. During historical conditions of scarcity, family life and resources were devoted to the procurement and preparation of foods, which are often low in energy, nutrients, and palatability. In sharp contrast, today in non-Third World countries children's eating habits develop under unprecedented conditions of dietary abundance, where palatable, inexpensive, ready-to-eat foods are readily available. (shrink)

Catherine Malabou in The New Wounded develops a general theory of trauma by extending her account of destructive plasticity to the realm of post-traumatic stress disorder. “The new wounded,” she claims, “all come together around a single fact: the radical rupture that trauma introduces in the psyche”. This rupture is demonstrated by an affective fissure, which renders traumatized persons emotionally and socially mute, and a temporal fissure, which punctures subjects’ relationships to their pasts, thus tearing them from any sociohistorical context. (...) Malabou’s new wounded are marked by extreme indifference and a new, unrecognizable identity created ex nihilo with total absence at its center; at times she... (shrink)

Internet-based health research is increasing, and often offers financial incentives but fraudulent behavior by participants can result. Specifically, eligible or ineligible individuals may enter the study multiple times and receive undeserved financial compensation. We review past experiences and approaches to this problem and propose several new strategies. Researchers can detect and prevent Internet research fraud in four broad ways: through the questionnaire/instrument ; through participants' non-questionnaire data and seeking external validation through computer information,, and 4) through study design. These approaches (...) each have pros and cons, and raise ethical, legal, and logistical questions, given that ethical tensions can emerge between preserving the integrity of research vs. protecting the privacy and confidentiality of study respondents. While past discussions concerning the ethics of online research have tended to focus on the participants' ability to trust the researchers, needs now arise to examine researchers' abilities to trust the participants. This analysis has several critical implications for future practice, policy, and research. (shrink)

This paper is one of four interrelated action papers resulting from the 2008 National Summit on Legal Preparedness for Obesity Prevention and Control. Summit participants engaged in discussions on the current state of the law with respect to obesity, nutrition and food policy, physical activity, and physical education. Participants also identified gaps in the law at all jurisdictional levels and relevant to numerous sectors and disciplines that have a stake in obesity prevention and control.The companion paper, “Assessment of Laws and (...) Legal Authorities for Obesity Prevention and Control,”identified numerous laws and policies enacted to target the three domains of healthy lifestyles, healthy places, and healthy societies. That paper identified several gaps in the law that require attention and action. This paper addresses those gaps and presents applicable laws and legal authorities that public health professionals and lawyers can consider to implement to close the gaps. (shrink)

Although underappreciated in his own day, Catholic convert John Henry Newman was remarkably prophetic about the challenges that lay ahead for the Catholic faith. In his 1873 sermon titled, ‘The Infidelity of the Future’, Newman warned of a time when the Church would face not only the cold indifference of agnosticism but also the targeted hostility of those opposed to both God and religion. Yet Newman was not without hope or wisdom for the future Church. This essay examines Newman's insistence (...) upon the need to cultivate an ‘ecclesiastical spirit’ and an ‘intelligent faith’. It specifically explores how Catholic institutions of higher education can respond to Newman's call and assist in bringing about a renewal in the evangelical mission of the Church, providing a much-needed alternative to the wisdom of the world. (shrink)

This paper is one of four interrelated action papers resulting from the 2008 National Summit on Legal Preparedness for Obesity Prevention and Control. Summit participants engaged in discussions on the current state of the law with respect to obesity, nutrition and food policy, physical activity, and physical education. Participants also identified gaps in the law at all jurisdictional levels and relevant to numerous sectors and disciplines that have a stake in obesity prevention and control.The companion paper, “Assessment of Laws and (...) Legal Authorities for Obesity Prevention and Control,”identified numerous laws and policies enacted to target the three domains of healthy lifestyles, healthy places, and healthy societies. That paper identified several gaps in the law that require attention and action. This paper addresses those gaps and presents applicable laws and legal authorities that public health professionals and lawyers can consider to implement to close the gaps. (shrink)

Bioethics, Volume 36, Issue 5, Page 535-546, June 2022.

This volume is a collection of 16 essays, old and new, relating history and exegesis in the writings of Bede and Adomnán, and in the lives of Thomas Becket. The first part consists of seven studies of Bede's writings, notably his biblical commentaries and his Ecclesiastical History. Two of the essays are published here for the first time. The five studies in the second part, devoted to Adomnán, discuss his life of Saint Columba (the Vita Columbae) and his guide to (...) the Holy Places (De locis sanctis). One essay ('The Bible as Map'), published posthumously, compares his presentation of a major theme, the earthly and heavenly Jerusalem, with the approach adopted by Bede. The third section consists of two essays on the lives of Thomas Becket that were composed shortly after his death. They examine, in the context of patristic exegesis, the biblical images invoked in the texts in order to show how the saint's biographers understood the complex relationship between hagiography and history. With the exception of the Jarrow Lecture on Bede and the essays on Becket, the studies in both parts were published originally in edited books, some of them now hard to come by. (shrink)

Lapses in ethical conduct by those in corporate and public authority worldwide have given business researchers and practitioners alike cause to re-examine the antecedents to personal ethical values. We explore the relationship between ethical values and an individual’s long-term orientation or LTO, defined as the degree to which one plans for and considers the future, as well as values traditions of the past. Our study also examines the role of work ethic and conservative attitudes in the formation of a person’s (...) long-term orientation and consequent ethical beliefs. Empirically testing these hypothesized relationships using data from 292 subjects, we find that long-term perspectives on tradition and planning indeed engender higher levels of ethical values. The results also support work ethic’s role in fostering tradition and planning, as well as conservatism’s positive association with planning. Additionally, we report how tradition and planning mediate the influence of conservatism and work ethic on the formation of ethical values. Limitations of the study and future research directions, as well as implications for business managers and academics, are also discussed. (shrink)

Recently, we reported that melanoma risk in redheads is linked not only to pale skin, but also to the synthesis of the pigment – called pheomelanin – that gives red hair its color. We demonstrated that pheomelanin synthesis is associated with increased oxidative stress in the skin, yet we have not uncovered the chemical pathway between the molecule pheomelanin and the DNA damage that drives melanoma formation. Here, we hypothesize two possible pathways. On one hand, pheomelanin might generate reactive oxygen (...) species (ROS) that directly or indirectly cause oxidative DNA damage. On the other hand, pheomelanin synthesis might consume cellular antioxidant stores and make the cell nucleus more vulnerable to other endogenous ROS. Uncovering the mechanistic pathway between pheomelanin and oxidative DNA damage will be an important step in developing strategies to lower melanoma risk in redheads. (shrink)

ABSTRACTThis study examines the types of verbal, pictorial, and multimodal metaphors in the genre of sex education picture books for young children in Mainland China. Although being an educational discourse genre that is essentially concerned with transmitting scientific facts, sex education picture books employ a range of metaphors that categorize and construe the biological knowledge of human reproduction in a way that not only facilitates young children’s understanding of scientific concepts but also instills in them particular values and moralities that (...) are socioculturally conditioned. An examination of the source domains from which the metaphors are drawn and the target domains onto which the metaphors are mapped reveals three types of metaphor, namely, personification, domestication, and cross-experience metaphors. The analysis of seven sex education picture books for pre-school children suggests that these types of metaphor are used purposefully for addressing pedagogical as well as ideological con... (shrink)

ObjectivePatient involvement is used to describe the inclusion of patients as active participants in healthcare decision-making and research. This study aimed to investigate incoming year 1 medical (MBChB) students’ attitudes and opinions regarding patient involvement in this context.MethodsWe established a staff–student partnership to formulate the design of an online research survey, which included Likert scale questions and three short vignette scenarios designed to probe student attitudes towards patient involvement linked to existing legal precedent. Incoming year 1 medical students (n=333) were (...) invited to participate in the survey before formal teaching commenced.ResultsSurvey data (49 participants) indicate that students were broadly familiar with, and supportive of, patient involvement in medical treatment. There was least support for patient involvement in conducting (23.9%), contributing to (37.0%) or communicating research (32.6%), whereas there was unanimous support for patients choosing treatment from a selection of options (100%).ConclusionIncoming members of the medical profession demonstrate awareness of the need to actively involve patients in healthcare decision-making but are unfamiliar with the utility and value of such involvement in research. Further empirical studies are required to examine attitudes to patient involvement in healthcare. (shrink)

There have been calls for mandatory vaccination legislation to be introduced into the UK in order to tackle the national and international rise of vaccine-preventable disease. While some countries have had some success associated with mandatory vaccination programmes, the Royal College of Paediatrics and Child Health insist this is not a suitable option for the UK, a country which has seen historical opposition to vaccine mandates. There is a lack of comprehensive data to demonstrate a direct link between mandatory vaccination (...) legislation and increased uptake. While there are examples whereby there has been an improvement, some studies suggest that comparable results can be obtained by strongly recommending vaccinations instead. The RCPCH insist that healthcare workers are ideally placed to engage and inform parents to make every interaction a ‘vaccine opportunity’. This paper calls for a principled, rational approach to interpretations of autonomy which underpin parental informed consent. MacLean’s concept of mutual persuasion could be a vehicle to ensuring parents are suitably informed of both the material risks associated with vaccine choices and to consider the rationality of their decisions, while ultimately upholding parental autonomy. It is argued that this, alongside infrastructural improvement, could create a more sustainable, long-term improvement in childhood vaccination rates in the UK than mandatory vaccination. (shrink)

The domain of children's social understanding, including understanding of one's own and others’ minds and emotions, has been the topic of much research over the past few decades. Social understandi...

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

Focal brain metabolic effects detected by proton magnetic resonance spectroscopy (MRS) in obsessive-compulsive disorder (OCD) represent prospective indices of clinical status and guides to treatment design. Sampling bilateral pregenual anterior cingulate cortex (pACC), anterior middle cingulate cortex (aMCC), and thalamus in 40 adult patients and 16 healthy controls, we examined relationships of the neurometabolites glutamate+glutamine (Glx), creatine+phosphocreatine (Cr), and choline-compounds (Cho) with OCD diagnosis and multiple symptom types. The latter included OC core symptoms (Yale-Brown Obsessive-Compulsive Scale - YBOCS), depressive symptoms (...) (Montgomery-Åsberg Depression Rating Scale - MADRS), and general functioning (Global Assessment Scale - GAS). pACC Glx was 9.7% higher in patients than controls. Within patients, Cr and Cho correlated negatively with YBOCS and MADRS, while Cr correlated positively with the GAS. In aMCC, Cr and Cho correlated negatively with MADRS, while Cr in thalamus correlated positively with GAS. These findings present moderate support for glutamatergic and cingulocentric perspectives on OCD. Based on our prior metabolic model of OCD, we offer one possible interpretation of these group and correlational effects as consequences of a corticothalamic state of elevated glutamatergic receptor activity alongside below-normal glutamatergic transporter activity. (shrink)

This chapter examines the romanitas of the Codex Amiatinus. It suggests that the choice of uncial script in Northumbria in the 660s and 670s was a political act and that the association of uncial script with Rome and the papal mission acted as a challenge to insular liturgical gospel-book traditions in Northumbria. The chapter analyses the romanitas of Wearmouth-Jarrow, assuming that Bishop Wilfrid's romanitas aimed to demonstrate to the Northumbrians the superiority of Rome over Iona and of St. Peter over (...) Columba. (shrink)

This collection of essays contains revised versions of papers delivered at a conference entitled “Duty, Interest, and Practical Reason: Aristotle, Kant, and the Stoics” that was organized by Stephen Engstrom and Jennifer Whiting at the University of Pittsburgh in 1994. One of the main aims of the conference was to bring together scholars on Aristotle, the Stoics, and Kant to reevaluate the common view that Greek and Kantian ethics represent fundamentally opposed conceptions of ethical theory and the roles of (...) morality and happiness in practical reasoning. According to a common view, the ancients are eudaimonists; they derive or justify the virtues by showing how they contribute to the agent’s own eudaimonia or happiness. By contrast, Kant sharply criticizes eudaimonism for deriving or justifying morality in terms of happiness. This criticism applies to eudaimonism of all sorts, even Stoic eudaimonism, which is perhaps closer in some respects to Kant’s own views, and of which he is somewhat less critical than he is of other forms of eudaimonism. For Kant, moral duty and respect for the moral law must be grounded in reason itself and cannot be made to depend on any independent standard. These and related assumptions about ancient and Kantian ethics have helped structure much contemporary systematic work in ethical theory, as well as common conceptions of these ethical traditions. But this common view has been under reexamination lately; some of the most interesting work in the history of ethics in recent years has been in Greek and Kantian ethics, and much of it challenges one or another aspect of the received view of the ethical theory and moral psychology of Kant or the Greeks. However, with some exceptions, renewed interest and recent work in these two traditions has proceeded in parallel. The conference aimed to correct this, by bringing together some of the most distinguished scholars of ancient and modern ethics to compare and assess the role of moral duty and happiness in the two traditions. Most of the essays have such a comparative assessment as their main theme; but even those that focus more exclusively on one of the traditions contribute indirectly to this comparative assessment. (shrink)

This article provides a critical appraisal of the case for healthcare being rationed away from older patients to those who are younger. After sketching a metaphysics of elderliness and reviewing clinical and economic cases for healthcare rationing, the article looks in depth at the most challenging case for age rationing known as the ‘fair innings’ case. This article rejects that case and makes an alternative case that fairness actually dictates against age rationing in favour of allocation on the basis of (...) need. It concludes with a call for a renewed ‘covenant between generations’, founded on the virtue of pietas. (shrink)

Controversy persists over the ethics of compensating research participants and providing posttrial benefits to communities in developing countries. Little is known about residents' views on these subjects. In this study, interviews about compensation and posttrial benefits from a hypothetical HIV vaccine trial were conducted in Uganda’s Rakai District. Most respondents said researchers owed the community posttrial benefits and research compensation, but opinions differed as to what these should be. Debates about posttrial benefits and compensation rarely include residents' views like these, (...) but future ones should. (shrink)

This paper discusses three cultural narratives that threaten the health of people with intellectual/developmental disabilities (IDD) and which have become more evident during the COVID-19 pandemic. These meta-narratives are the medical model of health/disability; the population health approach to health inequalities; and policies premised on the assumption of the importance of national economic growth as an incentive for reducing health inequalities. Evidence exists that health research is more likely to become policy if it fits within a medical model and addresses (...) national economic growth. These two criteria are particularly problematic for people who have IDD. The paper also proposes a research model to facilitate the inclusion of IDD related issues in future policy regarding health inequalities. (shrink)

Law is an essential tool for public health practice, and the use of a systematic legal framework can assist with preventing chronic diseases and addressing the growing epidemic of obesity.The action options available to government at the federal, state, local, and tribal levels and its partners can help make the population healthier by preventing obesity and decreasing the growing burden of associated chronic diseases such as cardiovascular disease and Type 2 diabetes. The Centers for Disease Control and Prevention uses the (...) four-part systematic legal framework commonly referred to as “public health legal preparedness” to demonstrate the essential role law can play for any public health issue. This paper uses the “laws and legal authorities” component of the framework and should be considered in combination with the competencies, coordination, and information-best practices components of the framework. (shrink)