The ICD-11 personality disorder model is the first fully dimensional assessment of personality pathology. It consists of a personality disorder dysfunction-severity dimension, which encompasses both self- and interpersonal dysfunction, and six optional qualifiers for five prominent personality traits—Negative Affectivity, Detachment, Dissociality, Disinhibition, and Anankastia —plus a borderline pattern that is defined by the criteria of DSM-IV borderline PD. This article reports on the development of a new self-report measure to assess self- and interpersonal dysfunction and the five trait qualifiers. It (...) is the first comprehensive measure of the ICD-11 PD model in that it is the only one to include both PD dysfunction-severity as well as trait scales and because it is based on the Clinical Description and Diagnostic Guidelines, which are more detailed than the “statistical” model description that is currently on the ICD-11 website. The authors wrote 992 items and then reduced the pool to 300 items by eliminating redundancy and selecting the consensus best few items for each subconstruct. Data were collected using an online sample of 383 Prolific workers. Using exploratory factor analysis, seven domain scales were developed, each of which contained two to four scales assessing components of the domain. These preliminary scales’ psychometrics were excellent, as were the domains’ and their components’ convergent and discriminant validity, with a few generally minor exceptions. Structural analyses at the component level revealed a three-factor structure consisting of two moderately correlated Internalizing factors, one centered on Self Dysfunction with two NA components and a DSN component and the other on Interpersonal Dysfunction with DET and ANK components; as well as an Externalizing factor with DSL and a DSN component that was uncorrelated with the other two factors. Two aspects of the results in particular are striking: ANK was not the opposite end of a DSN dimension, but rather contributed to an Internalizing Interpersonal Dysfunction dimension and DSN had both an Internalizing and an Externalizing component. Implications of the findings and study limitations are discussed. (shrink)

of (from British Columbia Philosophy Graduate Conference) In response to the “Causal Drainage” objection to his Supervenience Argument, Kim introduces micro-based properties and argues that their presence prohibits any causal drainage between metaphysical levels. Noordhof disagrees and instead argues that the causal powers of the �micro-bases� of micro-based properties seem to preempt the causal powers of micro-based properties, in much the same way as Kim claims the powers of subvening base properties preempt the powers of supervenient properties. Thus Noordhof argues (...) that the causal powers of higher-level micro-based properties still seem to drain downward to their lower-level micro-bases. In this paper I will defend Noordhof and argue that in fact this drainage is due to the fact that micro-based properties seem to supervene on their micro-bases. I thus argue that micro-based properties fall victim to the very same Supervenience Argument that Kim himself presents and I conclude that even micro-based properties turn out to be causally impotent if Kim�s Supervenience Argument is sound. (shrink)

BackgroundThe merits and drawbacks of moral relevance models of addiction have predominantly been discussed theoretically, without empirical evidence of these potential effects. This study develops and evaluates a novel survey measure for assessing moral evaluations of patient substance misuse (ME-PSM).MethodsThis measure was tested on 524 health professionals (i.e., physicians, nurses, and other health professionals) in California (n = 173), urban France (n = 102), and urban China (n = 249). Demographic factors associated with ME-PSM were investigated using analyses of variance (...) (ANOVAs) and t-tests, with results suggesting that ME-PSM is higher among younger health professionals, nurses (when compared with physicians and other health professionals), and Chinese health professionals (when compared with French and American health professionals).ResultsResults provide preliminary support for the psychometric quality of the survey measure introduced in this study, including the existence of a single latent structure and partial invariance of collected data across countries.ConclusionThe survey measure for ME-PSM which was developed and tested in the current study appears to hold potential utility for use as a measure of moral views of patient substance misuse. With development, this measure may be used to examine moral evaluations, both as factors of stigma and of other clinical factors associated with the treatment of patients with substance use disorders. (shrink)

Nurses are responsible for the well-being and quality of life of many people, and therefore must meet high standards of technical and ethical competence. The most common form of ethical guidance is a code of ethics/professional practice; however, little research on how codes are viewed or used in practice has been undertaken. This study, carried out in six European countries, explored nurses’ opinions of the content and function of codes and their use in nursing practice. A total of 49 focus (...) groups involving 311 nurses were held. Purposive sampling ensured a mix of participants from a range of specialisms. Qualitative analysis enabled emerging themes to be identified on both national and comparative bases. Most participants had a poor understanding of their codes. They were unfamiliar with the content and believed they have little practical value because of extensive barriers to their effective use. In many countries nursing codes appear to be ‘paper tigers’ with little or no impact; changes are needed in the way they are developed and written, introduced in nurse education, and reinforced/implemented in clinical practice. (shrink)

Joint actions often require agents to track others’ actions while planning and executing physically incongruent actions of their own. Previous research has indicated that this can lead to visuomotor interference effects when it occurs outside of joint action. How is this avoided or overcome in joint actions? We hypothesized that when joint action partners represent their actions as interrelated components of a plan to bring about a joint action goal, each partner’s movements need not be represented in relation to distinct, (...) incongruent proximal goals. Instead they can be represented in relation to a single proximal goal – especially if the movements are, or appear to be, mechanically linked to a more distal joint action goal. To test this, we implemented a paradigm in which participants produced finger movements that were either congruent or incongruent with those of a virtual partner, and either with or without a joint action goal (the joint flipping of a switch, which turned on two light bulbs). Our findings provide partial support for the hypothesis that visuomotor interference effects can be reduced when two physically incongruent actions are represented as mechanically interdependent contributions to a joint action goal. (shrink)

Federal regulations in the United States have shaped Institutional Review Boards to focus on protecting individual human subjects. Health services research studies focusing on healthcare institutions such as hospitals or clinics do not have individual human subjects. Since U.S. federal regulations are silent on what type of review, if any, these studies require, different IRBs may approach similar studies differently, resulting in undesirable variation in the review of studies focusing on healthcare institutions. Further, although these studies do not focus on (...) individual human subjects, they may pose risks to participating institutions, as well as individuals who work at those institutions, if identifying information becomes public. (shrink)

What does it mean to be black in America, to exist as a dark physical body, a "colored" voice, a stigmatized being in a society that sees, hears, and acts according to a set of bleaching assumptions? Versions of that question have echoed across our historical landscape ever since James-town, but rarely have they figured so forcibly as in the 1890s, when the Supreme Court upheld Ferguson over Plessy, Jim Crow laws spread through the South, degenerationists elaborated the "problem of (...) the Negro," imperialists hoisted the "white man's burden" of "little brown brothers" abroad, and racial lynching peaked at an all-time high that incited a national scandal. Any radical hopes for Reconstruction after the Civil War had long since vanished by the years of the fin de siècle. And a century later, the gains of a "Second Reconstruction" movement for civil rights have likewise eroded, with unparalleled "hypersegregation" accentuating new patterns of black poverty, unemployment, family disintegration, homelessness, and addiction.1 Being black, in other words, has meant—and, to a considerable degree, continues to mean—being excluded from white society, white prerogatives, even white discourse itself, in a process whose effects insidiously appear to legitimate the very causes that produce them. 1. C. Vann Woodward first warned of this unsettling repetition of nineteenth-century patterns in his 1965 suggestion that the civil rights movement might constitute a "Second Reconstruction" . In his recent reassessment of the troubling implications of that prediction, he notes how ghetto speech is growing more distinct from standard English: "The result is a vicious circle in which the longer blacks are made victims of the white stereotypes that foster hypersegregation, the more they appear to conform to the stereotypes that were used to justify segregation in the first place, and the deeper victims sink in isolation" . Lee Clark Mitchell, professor of English at Princeton University, is the author of Witnesses to a Vanishing America: The Nineteenth-Century Response and Determined Fictions: American Literary Naturalism . He is currently working on the formula western in a book tentatively titled "Writing Westward: Imagining America beyond the Frontier.". (shrink)

Deception is a reasonably common part of daily life that society sometimes demonstrates a degree of acceptance of, and occasionally people are very willing to be deceived. But can a computer identify deception and distinguish it from that which is not deceptive? We explore deception in various guises, differentiating it from lies, and highlighting the influence of medium and message in both deception and its detection. Our investigations to date have uncovered disagreements relating to the measurements of such cues, and (...) variations in interpretations, as could be problematic in building a deception detection system. (shrink)

BackgroundWe conducted a survey to identify what types of health/medical research could be exempt from research ethics reviews in Australia.MethodsWe surveyed Australian health/medical researchers and Human Research Ethics Committee members. The survey asked whether respondents had previously changed or abandoned a project anticipating difficulties obtaining ethics approval, and presented eight research scenarios, asking whether these scenarios should or should not be exempt from ethics review, and to provide comments. Qualitative data were analysed thematically; quantitative data in R.ResultsWe received 514 responses. (...) Forty-three per cent of respondents to whom the question applied, reported changing projects in anticipation of obstacles from the ethics review process; 25% reported abandoning projects for this reason. Research scenarios asking professional staff to provide views in their area of expertise were most commonly exempted from ethics review ; scenarios involving surplus samples and N-of-1 studies were most commonly required to undergo ethics review. HREC members were 26% more likely than researchers to require ethics review. Need for independent oversight, and low risk, were most frequently cited in support of decisions to require or exempt from ethics review, respectively.ConclusionsConsiderable differences exist between researchers and HREC members, about when to exempt from review the research that ultimately serves the interests of patients and the public. It is widely accepted that evaluative research should be used to reduce clinical uncertainties—the same principle should apply to ethics reviews. (shrink)

Recent studies show that racism still exists in the American medical profession, the fact of which legitimizes the historically long-legacy of mistrust towards medical profession and health authorities among African Americans. Thus, it was suspected that the participation of black patients in end-of-life care has always been significantly low stemmed primarily from their mistrust of the medical profession. On the other hand, much research finds that there are other reasons than the mistrust which makes African Americans feel reluctant to the (...) end-of-life care, such as cultural-religious difference and genuine misunderstanding of the services. If so, two crucial questions are raised. One is how pervasive or significant the mistrust is, compared to the other factors, when they opt out of the end-of-life care. The other is if there is a remedy or solution to the seemingly broken relationship. While no studies available answer these questions, we have conducted an experiment to explore them. The research was performed at two Philadelphia hospitals of Mercy Health System, and the result shows that Black patients’ mistrust is not too great to overcome and that education can remove the epistemic obstacles as well as overcome the mistrust. (shrink)

A great deal of scholarship defines rational thought in terms of probability theory. An important problem with such an approach is that disasters, particularly large disasters, do not provide us with a meaningful distribution of events that would approximate a normal curve. Here, I propose that using possibilistic thinking can helpfully complement probabilistic thinking regarding risk and disaster. Possibilistic thinking highlights consequences of actions or events, while not ignoring their likelihood of occurrence. I point out the myriad ways that individuals (...) and organizations use possibilistic thinking, even if they do not recognized it as such. I propose several conceptual tools to help discipline a possibilistic approach. (shrink)

The research teachers carry out into their own professional practice and environment is increasingly recognised as highly relevant and valuable. As well as being an exciting and fulfilling kind of research to carry out, it informs both policy and practice in education, constitutes a key resource for teachers, teacher educators and policy makers and is important for professional development. Bringing together accounts of teacher research projects from all over the world and from all sectors of education, _Teacher Inquiry: Living the (...) Research in Everyday Practice_ covers: * The practicalities of initiating and conducting teacher research; * The different models and methodologies available to teacher researchers; * The issues surrounding, and emerging from teacher research. The editors' introduction provides insight into the reasons for undertaking teacher inquiry, its valuable role in contemporary education and what new directions this form of research might take in the future. The collection reflects the incredible diversity of teacher research, and is a rich source of both information and inspiration for any teacher embarking on, or thinking of conducting, research into their own professional context. (shrink)

Chapter one Introduction The lexicon has come to play an increasingly important role in generative grammar. The first widely read monograph on generative ...

The last several decades have witnessed an explosion of new empirical research into representations of the past and the conditions of their production, prompting claims that we have entered a new era in which the past has become more “present” than ever before. Contemplating Historical Consciousness brings together leading historians, ethnographers, and other scholars who give illuminating reflections on the aims, methods, and conceptualization of their own research as well as the successes and failures they have encountered. This rich collective (...) account provides valuable perspectives for current scholars while charting new avenues for future research. (shrink)

The paper identifies a view of work that has become prominent in recent years: The view in question is that work is “split” into two main forms: “manual” and “intellectual.” These two forms of work are seen socially as being completely opposed to one another and stereotypes abound on both sides about the people who do them. The paper calls this view “The Manichean View of Work” after the Ancient Persian religion. It is argued that this view is based on (...) an erroneous philosophical position of dualism, a split between mind and body, that derives from the Greeks and was formalised by such thinkers as Ibn Sina and Rene Descartes, which has filtered down into all of Western society. A new, more inclusive definition of work is offered, along with criticisms of the “Manichean View.” Lastly, as a counter to the Western view, an argument based on Zen Buddhist philosophy, which views manual work positively, is given before some practical ways by which the split can be healed as a conclusion. (shrink)

The endoplasmic reticulum (ER) organelle is the key intracellular site of both protein and lipid biosynthesis. ER dysfunction, termed ER stress, can result in protein accretion within the ER and cell death; a pathophysiological process contributing to a range of metabolic diseases and cancers. ER stress leads to the activation of a protective signalling cascade termed the Unfolded Protein Response (UPR). However, chronic UPR activation can ultimately result in cellular apoptosis. Emerging evidence suggests that cells undergoing ER stress and UPR (...) activation can release extracellular signals that can propagate UPR activation to target tissues in a cell non‐autonomous signalling mechanism. Separately, studies have determined that the UPR plays a key regulatory role in the biosynthesis of bioactive signalling lipids including sphingolipids and ceramides. Here we weigh the evidence to combine these concepts and propose that during ER stress, UPR activation drives the biosynthesis of ceramide lipids, which are exported and function as cell non‐autonomous signals to propagate UPR activation in target cells and tissues. (shrink)

This paper was motivated by what we see as an inconsistency between a 1988 paper by Brennan and Buchanan expressing concern that public choice might erode public confidence in government and previous work by Buchanan, in particular Buchanan. The one advantage we saw with the 1988 paper was that it, all by itself, is all one needs to dismiss MacLean’s depiction of Buchanan as an ideologically rigid extremist. We also found the same inconsistency occurring simultaneously in Buchanan’s writing in 1979. (...) Yet, based on Wagner, we conclude that such inconsistencies may reflect a strength in Buchanan’s scholarship. (shrink)

This article explores the teaching of Fratelli tutti as an integrating document of the papacy of Francis. Exploring the title as greeting and imperative, the authors make a case for exploring FT as both a development of the themes of earlier social encyclicals and as an attempt to explore an integral humanism for a new age facing economic, environmental, migratory, and social-conflictual challenges. The article lays out a summary of these main themes of Francis’s social teaching. Nonetheless, the authors conclude, (...) the integral planetary humanism that Francis calls for, and is so needed, is itself a radically incomplete project. A common home is not possible without a recognition of a common kinship, yet without deep reflection on women’s experience, the inclusion of women as full subjects and agents of CST, and greater attention to race, the document cannot fully embody the spirit and logic of its own message of gift, inclusion, and co-belonging. (shrink)

abstract: The debate between St. Augustine of Hippo and the British monk Pelagius is a famous event in the history of Christianity. While Pelagius emphasized the idea that we could achieve salvation via our own free effort, Augustine argued for the opposite: That due to original sin, humans are unable to reach liberation alone and must be saved by God's grace. Augustine won the debate, and the doctrine of original sin became a key theological cornerstone of Western Christianity. What is (...) less well known is that two philosophical positions within the Buddhist tradition corresponded to this debate. One from the Buddha Shakyamuni himself, who taught that all could attain nirvana freely, and one from the medieval Japanese monk and philosopher Shinran, who, disagreeing with his master, taught that we live in a fallen era. We are unable to achieve enlightenment ourselves and thus must rely on the saving grace of Amida Buddha to transport us to a place where the goal is achievable. This paper seeks to highlight these similarities between these two debates and, in the process, show that the philosophical issue of free will versus determinism is one that crosses the boundaries of Eastern and Western thought. It is hoped that the revelation of such a shared debate will increase understanding between Christianity and Buddhism, as well as between other diverse traditions of thought. (shrink)

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

This paper is a study about Philadelphia’s comprehensive user engagement sites (CUESs) as the authors address and examine issues related to the upcoming implementation of a CUES while seeking solutions for its disputed questions and plans. Beginning with the federal drug schedules, the authors visit some of the medical and public health issues vis-à-vis safe injection facilities (SIFs). Insite, a successful Canadian SIF, has been thoroughly researched as it represents a paradigm for which a Philadelphia CUES can expand upon. Also, (...) the existing criticisms against SIFs are revisited while critically unpackaged and responded to in favor of the establishment. In the main section, the authors propose the layout and services of the upcoming CUES, much of which would be in congruent to Vancouver’s Insite. On the other hand, the CUES would be distinct from Insite, as the authors emphasize, in that it will offer an information center run by individuals in recovery and place additional emphasis on early education for young healthcare professionals by providing them a platform to work at the site. The paper will also briefly investigate the implementation of a CUES site under an ethical scope of the Harm Reduction Theory. Lastly, the authors recommend some strategic plans that the Philadelphia City government may consider employing at this crucial stage. (shrink)

Ebola is a deadly disease with no cure; there is no vaccine developed yet. Many died during the 2014 outbreak in West Africa, and many healthcare professionals went to the virus infected area to treat the patients while placing their lives in danger. Not every medical professional placed in the field is a fully trained specialist, and sometimes one or two under-trained doctors are in charge of the entire clinic with some nurses and operating technicians. When unexpected outbreaks of the (...) virus occur in the places, the doctor(s) would encounter medical and ethical dilemmas. Should they leave or stay? In fact, this dilemma is not confined to the Ebola pandemic but relevant to all similar cases. In this paper, three authors, a medical resident, a clinical bioethicist, and a theoretical bioethicist respond to the dilemma. (shrink)

The Deaf culture in the United States is a unique culture that is not widely understood. To members of the Deaf community in the United States, deafness is not viewed as a disease or pathology to be treated or cured; instead it is seen as a difference in human experience. Members of this community do not hide their deafness; instead they take great pride in their Deaf identity. The Deaf culture in the United States is very communitarian not individualistic. Mary (...) Beth and Dominic are a married couple in their late 20s who are genetically deaf. They are active members in the Deaf community and work as advocates for individuals who are deaf, family members of Deaf people and sign language interpreters who identify with the Deaf culture. Mary Beth and Dominic approach the fertility clinic with a request that they only want a child with the genetic gene for deafness. They would want the embryos that do not have the gene to be destroyed. This would entail creating a child who would have the gene for deafness. Medically and ethically, should the fertility clinic agree to the couple’s request? The authors argue that the couple's request should be denied and provide reasons for it from the perspectives of foundational and clinical ethics. (shrink)