We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

The goal of this study was to assess the relationships between computational approaches to analyzing constructed responses made during reading and individual differences in the foundational skills of reading in college readers. We also explored if these relationships were consistent across texts and samples collected at different institutions and texts. The study made use of archival data that involved college participants who produced typed constructed responses under thinking aloud instructions reading history and science texts. They also took assessments of vocabulary (...) knowledge and proficiency in comprehension. The protocols were analyzed to assess two different ways to determine their cohesion. One approach involved assessing how readers established connections with themselves. The other approach involved assessing connections between the constructed responses and the texts that were read. Additionally, the comparisons were made by assessing both lexical and semantic comparisons. The result showed that both approaches for analyzing cohesion and making the comparisons were correlated with vocabulary knowledge and comprehension proficiency. The implications of the results for theory and practice are discussed. (shrink)

BackgroundThe U.S. Food and Drug Administration traditionally has kept confidential significant amounts of information relevant to the approval or non-approval of specific drugs, devices, and biologics and about the regulatory status of such medical products in FDA’s pipeline.ObjectiveTo develop practical recommendations for FDA to improve its transparency to the public that FDA could implement by rulemaking or other regulatory processes without further congressional authorization. These recommendations would build on the work of FDA’s Transparency Task Force in 2010.MethodsIn 2016-2017, we convened (...) a team of academic faculty from Harvard Medical School, Brigham and Women’s Hospital, Yale Medical School, Yale Law School, and Johns Hopkins Bloomberg School of Public Health to develop recommendations through an iterative process of reviewing FDA’s practices, considering the legal and policy constraints on FDA in expanding transparency, and obtaining insights from independent observers of FDA.ResultsThe team developed 18 specific recommendations for improving FDA’s transparency to the public. FDA could adopt all these recommendations without further congressional action.FundingThe development of the Blueprint for Transparency at the U.S. Food and Drug Administration was funded by the Laura and John Arnold Foundation. (shrink)

Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better understood (...) as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)

In this new textbook two Catholic ethicists with extensive teaching experience present a moral theology based on vision. David Matzko McCarthy and James M. Donohue draw widely from the Western philosophical tradition while integrating biblical and theological themes in order to explore such fundamental questions as What is good? The fourteen chapters in Moral Vision are short and thematic. Substantive study questions engage with primary texts and encourage students to apply theory to everyday life and common human experiences. The (...) book is accessibly written and flexible enough to fit into any undergraduate or seminary course on ethics. (shrink)

This paper makes the case for a pluralist, contextualist view of nursing ethics. In defending this view, I briefly outline two current perspectives of nursing ethics – the Traditional View and the Theory View. I argue that the Traditional View, which casts nursing ethics as a subcategory of healthcare ethics, is problematic because it (1) fails to sufficiently acknowledge the unique nature of nursing practice; and (2) applies standard ethical frameworks such as principlism to moral problems which tend to alienate (...) or undermine nursing ethical concerns. Alternatively, the Theory View, which aims to build an independent and comprehensive theory of nursing ethics, is also found wanting because it (1) fails to sufficiently acknowledge the heterogeneous nature of nursing practices; (2) overemphasizes the differences and undervalues the similarities between nurses and other health professionals; and (3) assumes that one ethical framework can be meaningfully applied across diverse moral problems and contexts.My alternative, is to argue that nursing ethics inquiry should take a pluralist and critical stance towards available ethical frameworks and the negotiation of the ethical realm. On this view, the search for moral consensus or a unique ethical framework for nursing is replaced by the task of working strategically with multiple frameworks in order to expand the moral agency of nurses and empower them to positively engage with moral uncertainty as an inevitable feature of living a moral life. I conclude by indicating some of the implications that this has for the teaching of nursing ethics. (shrink)

Reliable medically assisted sex selection which does not involve abortion or infanticide has recently become available, and has been used for non-medical reasons. This raises questions about the morality of sex selection for non-medical reasons. But reasonable people continue to disagree about the answers to these questions. So another set of questions is about what the law should be on medically assisted sex selection for non-medical reasons in the face of reasonable disagreement about the morality of sex selection. This paper (...) sketches a way of thinking about what the law should be, and concludes, contrary to what the law is in many places, that medically assisted sex selection for non-medical reasons ought to be legal. (shrink)

The potential to collect brain data more directly, with higher resolution, and in greater amounts has heightened worries about mental and brain privacy. In order to manage the risks to individuals posed by these privacy challenges, some have suggested codifying new privacy rights, including a right to “mental privacy.” In this paper, we consider these arguments and conclude that while neurotechnologies do raise significant privacy concerns, such concerns are—at least for now—no different from those raised by other well-understood data collection (...) technologies, such as gene sequencing tools and online surveillance. To better understand the privacy stakes of brain data, we suggest the use of a conceptual framework from information ethics, Helen Nissenbaum’s “contextual integrity” theory. To illustrate the importance of context, we examine neurotechnologies and the information flows they produce in three familiar contexts—healthcare and medical research, criminal justice, and consumer marketing. We argue that by emphasizing what is distinct about brain privacy issues, rather than what they share with other data privacy concerns, risks weakening broader efforts to enact more robust privacy law and policy. (shrink)

Business orientation toward sustainable development goals and the circular economy are relevant research topics today in business theory and practice. The waste recycling sector is a key industry in the circular economy framework for promoting clean production and environmental sustainability. This study analyzes business performance in the recycling sector, focusing on efficiency indicators. The associations between firm efficiency and risk variables were also evaluated. The study goes through several methodological stages, including a Data Envelopment Analysis (DEA) multistage method and multivariate (...) modeling: tobit regression, bootstrap models, and generalized method of moments (GMM). The main results indicate that the average efficiency of waste recycling firms is at a medium level. Large-sized firms achieve higher levels of efficiency than medium-sized and small firms, supporting the economies of scale hypothesis. The evidence also suggests that risk variables (rating score and Zscore) and capital structure are key determinants of firm efficiency in the waste recycling industry. (shrink)

This book proposes a new theory of the origins of human language ability and presents an original account of the early evolution of language. It explains why humans are the only language-using animals, challenges the assumption that language is a consequence of intelligence, and offers a new perspective on human uniqueness. The author draws on evidence from archaeology, linguistics, cognitive science, and evolutionary biology. Making no assumptions about the reader's prior knowledge he first provides an introductory but critical survey of (...) all sources of evidence for language evolution. He then considers what language itself reveals about its own and human origins and evolution. He shows that certain central aspects of language do not, unexpectedly, reflect what they are used for, are maladapted for their function. He considers why this should be, and argues that these odd aspects of language reveal important clues about its evolutionary origin. The Origins of Complex Language fulfils the promise of its title. In doing so it turns upside down conventional theories about the relation between cognition and expression, truth and reference, and the co-evolution of mind and body. Original in conception, brilliantly executed, stylishly written, this book will attract a wide range of readers interested in the evolution and origins of language. (shrink)

In this important volume Habermas outlines the views which form the basis of his critical theory of modern societies. The volume comprises five interlocking essays, which together define the contours of his theory of communication and of his substantive account of social change. ′What is Universal Pragmatics?′ is the best available statement of Habermas′s programme for a theoryof communication based on the analysis of speech acts. In the following two essays Habermas draws on the work of Kohlberg and others to (...) develop a distinctive account of moral consciousness and normative structures. ′Toward a Reconstruction of historical Materialsim′ takes these issues further, offering a wide–ranging reconstruction of Marx′s historical materialsim understood as a theory of social evolution. The final essay focuses on the question of legitimacy and on the legitimation problems faced by modern states. This book is essential reading for anyone concerned with the key questions of social and political theory today. (shrink)

Jurgen Habermas is unquestionably one of the foremost philosophers writing today. His notions of communicative action and rationality have exerted a profound influence within philosophy and the social sciences. This volume examines the historical and intellectual contexts out of which Habermas' work emerged, and offers an overview of his main ideas, including those in his most recent publication. Amongst the topics discussed are his relationship to the Frankfurt School of critical theory and Marx, his unique contributions to the philosophy of (...) the social sciences, the concept of 'communicative ethics', and the critique of post-modernism. New readers and non-specialists will find this the most convenient, accessible guide to Habermas currently available. Advanced students will find a conspectus of recent developments in the interpretation of Habermas. (shrink)

Philosophers often assume that we can somehow quantitatively measure how good things are for people. But what does such talk mean? And what are the measures? In *Weighing Goods* John Broome offers one treatment of these questions. In his later *Weighing Lives* he offers a different treatment. This article discusses both positions but advocates a third. But while the three positions disagree about matters of meaning, they agree about the form of the measures. Roughly speaking, they are such that the (...) goodness of a lottery for an individual is equal to its expected goodness for her. (shrink)

As library collections and services have increasingly moved from print to digital, much of the work that used to be done by libraries themselves with regard to creating, maintaining, and managing the systems that hold collections and facilitate user access to them is now done primarily by vendors. This change to the information services landscape for academic libraries is the occasion not only of technical and procedural challenges, but also some internal conflicts concerning the ethical demands of the library profession. (...) This essay examines the ways in which these conflicts become acute and obvious when attention is paid to the way in which attempts to promote equity, diversity, and inclusion (EDI) are undermined by the handover of library services to vendors, even when—or perhaps especially when—those vendors use their control of content and platforms to commodify diverse content instead of making the necessary systemic changes required by truly effective EDI efforts. (shrink)

GraphicalThe need to encourage individuals as active change agents for sustainability transitions has led researchers across disciplines to conceptualize over 70 constructs to assess relevant dispositions to environmental protection and green consumption behaviors. The generated knowledge is, however, fragmented by an unconsolidated set of constructs developed within parallel literature streams. We, hence, use an integrative review method to capture conceptual and operational similarities and distinctiveness of constructs across disciplines in the literature, attempting to unify the knowledge base. Thereby, we identify (...) 34 conceptually distinct constructs relevant for the thematic synthesis on individual-level constructs framing contributions to environmental measures and issues. We followingly propose a taxonomy, systemizing constructs based on their concept type and contextual scope of the environmental challenge addressed. We capture these dimensions in critically assessing relevant and salient conceptual and operational features. We thus create a consolidated picture of extant constructs capturing individual-level environmental sustainability by which we intend a three-fold contribution to the interdisciplinary field. First, the taxonomy and guiding framework for the choice of constructs should assist substantive researchers in identifying appropriate constructs of interest. Second, the systematic integration of similar concepts available in parallel literature streams should assist future endeavors aiming at integrating substantive findings with regard to antecedents, consequences, and other relevant variables. Finally, the taxonomy revealed that conceptualizations mainly scatter around specific combinations of types and scopes while others remain unaddressed. Based on our critical assessment of the relevant features and resulting taxonomy, we identify avenues for future research dedicated to enhancing conceptual rigor and measurement quality in the field and introducing concepts addressing missing but potentially valuable combinations of types and scopes. We conclude that researchers engaging in the proposed avenues with conceptual, methodological, or empirical contributions should consider four critical aspects to advance knowledge accumulation and prevent fragmentation in the interdisciplinary field. We thereby hope to pave the way for a collective, interdisciplinary knowledge base of concepts used to describe and assess individual’s pro-environmental dispositions and practices of green consumption. (shrink)

In this comprehensive new study of human free agency, Laura Waddell Ekstrom critically surveys contemporary philosophical literature and provides a novel account of the conditions for free action. Ekstrom argues that incompatibilism concerning free will and causal determinism is true and thus the right account of the nature of free action must be indeterminist in nature. She examines a variety of libertarian approaches, ultimately defending an account relying on indeterministic causation among events and appealing to agent causation only in (...) a reducible sense. Written in an engaging style and incorporating recent scholarship, this study is critical reading for scholars and students interested in the topics of motivation, causation, responsibility, and freedom. In broadly covering the important positions of others along with its exposition of the author’s own view, Free Will provides both a significant scholarly contribution and a valuable text for courses in metaphysics and action theory. (shrink)

In this unique and comprehensive book, George McCarthy examines the influence of Greek philosophy, literature, arts, and politics on the development of twentieth-century German social thought. McCarthy demonstrates that the classical spirit vitalized thinkers such as Weber, Heidegger, Freud, Marcuse, Arendt, Gadamer, and Habermas. With the romancing of antiquity, they transformed their understanding of the modern self, political community, and Enlightenment rationality. By viewing contemporary social theory from the framework of the classical world, McCarthy argues, we are (...) capable of thinking beyond the limits of modernity to new possibilities of human reason, science, beauty, and social justice. (shrink)

The orthodox view of anger takes desires for revenge or retribution to be central to the emotion. In this paper, I develop an empirically informed challenge to the retributive view of anger. In so doing, I argue that a distinct desire is central to anger: a desire for recognition. Desires for recognition aim at the targets of anger acknowledging the wrong they have committed, as opposed to aiming for their suffering. In light of the centrality of this desire for recognition, (...) I argue that the retributive view of anger should be abandoned. I consider and dismiss two types of moves that can be made on the part of a proponent of the orthodox view in response to my argument. I propose that a pluralist view, which allows for both retribution and recognition in anger, is to be preferred. (shrink)

The Covid‐19 pandemic has highlighted many of the difficult ethical issues that health care professionals confront in caring for patients and families. The decisions such workers face on the front lines are fraught with uncertainty for all stakeholders. Our focus is on the implications for nurses, who are the largest global health care workforce but whose perspectives are not always fully considered. This essay discusses three overarching ethical issues that create a myriad of concerns and will likely affect nurses globally (...) in unique ways: the safety of nurses, patients, colleagues, and families; the allocation of scarce resources; and the changing nature of nurses’ relationships with patients and families. We urge policy‐makers to ensure that nurses’ voices and perspectives are integrated into both local and global decision‐making so as to minimize the structural injustices many nurses have faced to date. Finally, we urge nurses to seek sources of support throughout this pandemic. (shrink)

We show that without assuming completeness or continuity, a strongly independent preorder on a possibly infinite dimensional convex set can always be given a vector-valued representation that naturally generalizes the standard expected utility representation. More precisely, it can be represented by a mixture-preserving function to a product of lexicographic function spaces.

ABSTRACTRecent research suggests that impaired emotion regulation may play an important role in the development of youth psychopathology. However, little research has explored the effects of ER strategies on affect in early adolescents. In Study 1, we examined if early adolescents are able to use distraction and whether the effects of this strategy are similar to talking to one’s mother. In Study 2, we compared the effects of distraction, cognitive reappraisal, acceptance, and rumination. In both studies, participants received instructions on (...) how to regulate their emotions after a standardised negative mood induction. In general, the results indicated that distraction, but also cognitive reappraisal and acceptance, had promising short-term effects on positive and negative affect in early adolescents. These findings suggest that targeting adaptive ER skills, such as distraction, acceptance, and cognitive reappraisal, may be an important strategy to prevent or treat psychological pro... (shrink)

Symbolic arithmetic is fundamental to science, technology and economics, but its acquisition by children typically requires years of effort, instruction and drill1,2. When adults perform mental arithmetic, they activate nonsymbolic, approximate number representations3,4, and their performance suffers if this nonsymbolic system is impaired5. Nonsymbolic number representations also allow adults, children, and even infants to add or subtract pairs of dot arrays and to compare the resulting sum or difference to a third array, provided that only approximate accuracy is required6–10. Here (...) we report that young children, who have mastered verbal counting and are on the threshold of arithmetic instruction, can build on their nonsymbolic number system to perform symbolic addition and subtraction11–15. Children across a broad socio-economic spectrum solved symbolic problems involving approximate addition or subtraction of large numbers, both in a laboratory test and in a school setting. Aspects of symbolic arithmetic therefore lie within the reach of children who have learned no algorithms for manipulating numerical symbols. Our findings help to delimit the sources of children’s difficulties learning symbolic arithmetic, and they suggest ways to enhance children’s engagement with formal mathematics. We presented children with approximate symbolic arithmetic problems in a format that parallels previous tests of non-symbolic arithmetic in preschool children8,9. In the first experiment, five- to six-year-old children were given problems such as ‘‘If you had twenty-four stickers and I gave you twenty-seven more, would you have more or less than thirty-five stickers?’’. Children performed well above chance (65.0%, t1952.77, P 5 0.012) without resorting to guessing or comparison strategies that could serve as alternatives to arithmetic. Children who have been taught no symbolic arithmetic therefore have some ability to perform symbolic addition problems. The children’s performance nevertheless fell short of performance on non-symbolic arithmetic tasks using equivalent addition problems with numbers presented as arrays of dots and with the addition operation conveyed by successive motions of the dots into a box (71.3% correct, F1,345 4.26, P 5 0.047)8.. (shrink)

While various definitions of moral distress have been proposed, some agreement exists that it results from illegitimate constraints in clinical practice affecting healthcare professionals’ moral agency. If we are to reduce moral distress, instruments measuring it should provide relevant information about such illegitimate constraints. Unfortunately, existing instruments fail to do so. We discuss here several shortcomings of major instruments in use: their inability to determine whether reports of moral distress involve an accurate assessment of the requisite clinical and logistical facts (...) in play, whether the distress in question is aptly characterized as moral, and whether the moral distress reported is an appropriate target of elimination. Such failures seriously limit the ability of empirical work on moral distress to foster appropriate change. (shrink)

Among “continental” philosophers there is general agreement that reason has to be understood as culturally mediated and embodied in social practice, and thus that the critique of reason should be carried out through some form of sociocultural analysis. At the same time, there is very sharp disagreement among them as to just what form the critique should take. In its most general terms, that disagreement has come to be known as the “modernity/postmodernity debate” in philosophy. Stylizing a bit, we might (...) characterize one side as attacking Enlightenment—especially Kantian—conceptions of reason and the rational subject at their very roots, and the other side as wanting to preserve such conceptions by transforming them. It is the merit of Richard Bernstein’s recent book to have reconstructed these abstruse metaphilosophical debates in generally comprehensible prose and to have indicated in the process the relevance of the pragmatist tradition to the issues they raise. (shrink)

"This book focuses on arguments from suffering against the existence of God and on a variety of issues concerning agency and value that they bring out. The central aim is to show the extent and power of arguments from evil. The book provides a close investigation of an under-defended claim at the heart of the major free-will-based responses to such arguments, namely that free will is sufficiently valuable to serve as the good, or prominently among the goods, that provides a (...) God-justifying reason for permitting evil in our world. Offering a fresh examination of traditional theodicies, it also develops an alternative line the author calls a divine intimacy theodicy. It makes an extended case for rejection of the position of skeptical theism. The book expands upon an argument from evil concerning a traditional doctrine of hell, which reveals a number of interesting issues concerning fault, agency, and blameworthiness. In response to recent work contending that the problem of evil is defanged since God's baseline attitude toward human beings is indifference, the book defends the essential perfect moral goodness of God. Finally it takes up the question of whether or not it makes sense to live a religious life as an agnostic or as an atheist"--. (shrink)

The American Society for Bioethics and Humanities has created a quality attestation process for clinical ethics consultants; the pilot phase of reviewing portfolios has begun. One aspect of the QA process which is particularly challenging is assessing the interpersonal skills of individual clinical ethics consultants. We propose that using case simulation to evaluate clinical ethics consultants is an approach that can meet this need provided clear standards for assessment are identified. To this end, we developed the Assessing Clinical Ethics Skills (...) tool, which identifies and specifies specific behaviors that a clinical ethics consultant should demonstrate in an ethics case simulation. The aim is for the clinical ethics consultant or student to use a videotaped case simulation, along with the ACES tool scored by a trained rater, to demonstrate their competence as part of their QA portfolio. The development and piloting of the tool is described. (shrink)

A mixture preorder is a preorder on a mixture space (such as a convex set) that is compatible with the mixing operation. In decision theoretic terms, it satisfies the central expected utility axiom of strong independence. We consider when a mixture preorder has a multi-representation that consists of real-valued, mixture-preserving functions. If it does, it must satisfy the mixture continuity axiom of Herstein and Milnor (1953). Mixture continuity is sufficient for a mixture-preserving multi-representation when the dimension of the mixture space (...) is countable, but not when it is uncountable. Our strongest positive result is that mixture continuity is sufficient in conjunction with a novel axiom we call countable domination, which constrains the order complexity of the mixture preorder in terms of its Archimedean structure. We also consider what happens when the mixture space is given its natural weak topology. Continuity (having closed upper and lower sets) and closedness (having a closed graph) are stronger than mixture continuity. We show that continuity is necessary but not sufficient for a mixture preorder to have a mixture-preserving multi-representation. Closedness is also necessary; we leave it as an open question whether it is sufficient. We end with results concerning the existence of mixture-preserving multi-representations that consist entirely of strictly increasing functions, and a uniqueness result. (shrink)