This chapter describes the potential far‐reaching consequences of contemplative higher education for the fields of science and medicine.

This unique textbook utilizes an integrated, case-based approach to explore how the domains of bioethics, public health and the social sciences impact individual patients and populations. It provides a structured framework suitable for both educators (including course directors and others engaged in curricular design) and for medical and health professions students to use in classroom settings across a range of clinical areas and allied health professions and for independent study. The textbook opens with an introduction, describing the intersection of ethics (...) and public health in clinical practice and the six key themes that inform the book's core learning objectives, followed by a guide to using the book. It then presents 22 case studies that address a broad spectrum of patient populations, clinical settings, and disease pathologies. Each pair of cases shares a core concept in bioethics or public health, from community perspectives and end-of-life care to medical mistakes and stigma and marginalization. They engage learners in rigorous clinical and ethical reasoning by prompting readers to make choices based on available information and then providing additional information to challenge assumptions, simulating clinical decision-making. In addition to providing a unique, detailed clinical scenario, each case is presented in a consistent format, which includes learning objectives, questions and responses for self-directed learning, questions and responses for group discussion, references, and suggested further reading. All cases integrate the six themes of patient- and family-centered care; evidence-based practice; structural competency; biases in decision-making; cultural humility and awareness of the culture of medicine; and justice, social responsibility and advocacy. The final section discusses some challenges to evaluating courses and learning encounters that adopt the cases and includes a model framework for learner assessment. (shrink)

hroughout medieval Christianity, religious works of art emerged to illustrate the teachings of the Bible for the largely illiterate population. What, then, is the significance of the psychoactive mushrooms hiding in plain sight in the artwork and icons of many European and Middle-Eastern churches? Does Christianity have a psychedelic history? -/- Providing stunning visual evidence from their anthropological journey throughout Europe and the Middle East, including visits to Roslyn Chapel and Chartres Cathedral, authors Julie and Jerry Brown document the (...) role of visionary plants in Christianity. They retrace the pioneering research of R. Gordon Wasson, the famous “sacred mushroom seeker,” on psychedelics in ancient Greece and India, and among the present-day reindeer herders of Siberia and the Mazatecs of Mexico. Challenging Wasson’s legacy, the authors reveal his secret relationship with the Vatican that led to Wasson’s refusal to pursue his hallucinogen theory into the hallowed halls of Christianity. -/- Examining the Bible and the Gnostic Gospels, the authors provide scriptural support to show that sacred mushrooms were the inspiration for Jesus’ revelation of the Kingdom of Heaven and that he was initiated into these mystical practices in Egypt during the Missing Years. They contend that the Trees of Knowledge and of Immortality in Eden were sacred mushrooms. -/- Uncovering the role played by visionary plants in the origins of Judeo-Christianity, the authors invite us to rethink what we know about the life of Jesus and to consider a controversial theory that challenges us to explore these sacred pathways to the divine. (shrink)

Brock Macdonald1, Evi Vakiani2, Rhonda K Yantiss3, Jun Lee4, Robert S Brown Jr5, Samuel H Sigal61Division of Gastroenterology, Department of Medicine, University of California-San Francisco, San Francisco, CA, 2Department of Pathology, Memorial Sloan–Kettering Cancer Center, New York, NY, 3Department of Pathology and Laboratory Medicine, New York Weill Cornell Medical College, New York, NY, 4Division of Nephrology, Department of Medicine, Weill Cornell Medical College, New York, NY, 5Division of Gastroenterology, Department of Medicine, Columbia University College of Physicians and Surgeons, New (...) York, NY, 6Division of Gastroenterology and Hepatology, Department of Medicine, New York University, New York, NY, USA: The use of sirolimus as an alternative to calcineurin inhibitors for posttransplant immunosuppression is associated with a variety of inflammatory conditions. In this report, we describe the case of a 34-year-old man who developed abnormal liver tests 6 years after live-donor kidney transplantation and 5 years after initiation of sirolimus-based immunosuppression. Elevated aminotransferase levels persisted after withdrawal of potentially hepatotoxic medications, and serologic evaluation for viral hepatitis, autoimmune disease, and genetic disorders was unrevealing. Liver biopsy revealed prominent hepatocellular injury associated with a mixed inflammatory infiltrate and liver tests normalized within 2 weeks of discontinuation of sirolimus. In this report, we review previous reports of sirolimus hepatotoxicity and propose a unifying hypothesis for the various inflammatory conditions that have been attributed to sirolimus.Keywords: sirolimus, immunosuppression, transplant, inflammatory conditions, hepatotoxicity. (shrink)

Background: Since the passage of the Patient Self-Determination Act, numerous policy mandates and institutional measures have been implemented. It is unknown to what extent those measures have affected end-of-life care, particularly with regard to the do-not-resuscitate order.Methods: Retrospective cohort study to assess associations of the frequency and timing of DNR orders with advance directive status, patient demographics, physician’s specialty and extent of documentation of discussion on end-of-life care.Results: DNR orders were more frequent for patients on a medical service than on (...) a surgical service and were made earlier in the hospital stay for medicine than for surgical patients . 22.18% of all patients had some form of an advance directive in their chart, yet this variable had no impact on the frequency or timing of DNR ordering. Documentation of DNR discussion was significantly associated with the frequency of DNR orders and the time from DNR to death .Conclusions: The physician’s specialty continues to have a significant impact on the frequency and timing of DNR orders, while advance directive status still has no measurable impact. Additionally, documentation of end-of-life discussions is significantly associated with varying DNR ordering rates and timing. (shrink)

Medicine is not merely a job that requires technical expertise, but a profession concerned with making the best decisions and recommendations with reference to, and in consultation with, the patient. This means that the skill set required for healthcare professionals in order to provide good care is a combination of scientific knowledge, technical aptitude, and affective qualities or virtues such as compassion and empathy.

Endosperm is emerging as a system for investigating the genetic control of wall placement and deposition in plant development. Development of endosperm progresses in distinct stages from a wall‐less syncytial stage to a cellular stage that is entirely typical of plant meristems where the division plane is predicted by a preprophase band of microtubules (PPB) and cytokinesis is completed by formation of a cell plate in association with a phragmoplast. Four developmentally different types of walls, each associated with a different (...) microtubule system, are sequentially produced: (1) free growing walls deposited in the absence of mitosis and phragmoplasts; (2) walls guided by cytoplasmic phragmoplasts formed adventitiously in the absence of mitosis; (3) walls formed by interzonal phragmoplasts in a cell cycle that lacks PPBs; and (4) wall deposition driven by interzonal phragmoplasts in a cycle that includes PPBs. We are using methods of differential screening to isolate cDNA clones corresponding in temporal and spatial pattern to the types of wall development, and are studying mutants for clues to the genetic controls of wall development. (shrink)

Legally blind participants were able to identify a visual stimulus attribute in the absence of consciously identifying its presence. Specifically, participants—with their corrective lenses removed—correctly guessed the hour-hand position above chance on a clockface shown on a computer screen. This occurred both when presented in a 1-clockface display , as well as when shown a display containing 4 clockfaces , in which only 1 face contained a hand. Even more striking, hand identification accuracy in the 4-clockface condition was comparable whether (...) the clockface containing the hand was or was not correctly identified. That legally blind individuals are capable of identifying stimulus attributes without conscious awareness provides an additional vehicle for exploring implicit perception. Consistent with previous research, the visualsystem can apparently cope with degraded visual input through information available through a secondary pathway via the superior colliculi. (shrink)

1 Evidence-based policy requires researchers to provide the answers to ecological questions that are of interest to policy makers. To find out what those questions are in the UK, representatives from 28 organizations involved in policy, together with scientists from 10 academic institutions, were asked to generate a list of questions from their organizations. 2 During a 2-day workshop the initial list of 1003 questions generated from consulting at least 654 policy makers and academics was used as a basis for (...) generating a short list of 100 questions of significant policy relevance. Short-listing was decided on the basis of the preferences of the representatives from the policy-led organizations. 3 The areas covered included most major issues of environmental concern in the UK, including agriculture, marine fisheries, climate change, ecosystem function and land management. 4 The most striking outcome was the preference for general questions rather than narrow ones. The reason is that policy is driven by broad issues rather than specific ones. In contrast, scientists are frequently best equipped to answer specific questions. This means that it may be necessary to extract the underpinning specific question before researchers can proceed. 5 Synthesis and applications. Greater communication between policy makers and scientists is required in order to ensure that applied ecologists are dealing with issues in a way that can feed into policy. It is particularly important that applied ecologists emphasize the generic value of their work wherever possible. (shrink)

At the forefront of international concerns about global legislation and regulation, a host of noted environmentalists and business ethicists examine ethical issues in consumption from the points of view of environmental sustainability, economic development, and free enterprise.

Hastings Center Report, Volume 52, Issue S1, Page S83-S88, March‐April 2022.

We approach the physics of \emph{minimal coupling} in general relativity, demonstrating that in certain circumstances this leads to violations of the \emph{strong equivalence principle}, which states that, in general relativity, the dynamical laws of special relativity can be recovered at a point. We then assess the consequences of this result for the \emph{dynamical perspective on relativity}, finding that potential difficulties presented by such apparent violations of the strong equivalence principle can be overcome. Next, we draw upon our discussion of the (...) dynamical perspective in order to make explicit two `miracles' in the foundations of relativity theory. We close by arguing that the above results afford us insights into the nature of special relativity, and its relation to general relativity. (shrink)

This paper investigates what the source of time-asymmetry is in thermodynamics, and comments on the question whether a time-symmetric formulation of the Second Law is possible.

Background Nursing students must graduate prepared to bravely enact the art and science of nursing in environments infiltrated with ethical challenges. Given the necessity and moral obligation of nurses to engage in discourse within nursing ethics, nursing students must be provided a moral supportive learning space for these opportunities. Situating conversations and pedagogy within a brave space may offer a framework to engage in civil discourse while fostering moral courage for learners. Research Objective The aim of this research is to (...) explore the influence of a structured self-assessment tool called the ESA “Engagement Self-Assessment” on the alignment and creation of a brave space in a nursing ethics course. Research Design This study used an exploratory, cross-sectional survey design. Participants and Study Setting Data from 39 undergraduate nursing students enrolled in a nursing healthcare ethics & law course using the ESA were recruited. Ethical Considerations Participation was voluntary and informed without coercion. Written consent was obtained prior to participation. Research ethics approval was obtained by the Institutional Research Ethics Board of the recruited participants (Ethics # 2022-23-03). Findings The ESA provided structured self-reflection on the impact of shared vulnerability within a brave space. However, commitment to a brave space was not strongly influenced by the ESA, but rather by a mutual “commitment to others.” Conclusion A teaching tool such as an ESA can be used to facilitate instructor expectations of civil discourse and discussion of difficult topics. Rules of engagement such as those found in brave spaces can help transform fear of vulnerability into authentic growth for learners. A morally supportive learning space can support critical opportunities for ethical development. This study provides insight into how self-assessment and the use of a brave space in nursing ethics education can facilitate a morally supportive learning space. (shrink)

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)

A moving cultural biography of abolitionist martyr John Brown, by one of the most important African-American intellectuals of the twentieth century. In the history of slavery and its legacy, John Brown looms large as a hero whose deeds partly precipitated the Civil War. As Frederick Douglass wrote: "When John Brown stretched forth his arm... the clash of arms was at hand." DuBois's biography brings Brown stirringly to life and is a neglected classic.

The aim of this paper is to illustrate four properties of the non-relativistic limits of relativistic theories: that a massless relativistic field may have a meaningful non-relativistic limt, that a relativistic field may have more than one non-relativistic limit, that coupled relativistic systems may be "more relativistic" than their uncoupled counterparts, and that the properties of the non-relativistic limit of a dynamical equation may differ from those obtained when the limiting equation is based directly on exact Galilean kinematics. These properties (...) are demonstrated through an examination of the non-relativistic limit of the familiar equations of first-quantized QED, i.e., the Dirac and Maxwell equations. The conditions under which each set of equations admits non-relativistic limits are given, particular attention being given to a gauge-invariant formulation of the limiting process especially as it applied to the electromagnetic potentials. The difference between the properties of a limiting theory and an exactly Galilean covariant theory based on the same dynamical equation is demonstrated by examination of the Pauli equation. (shrink)

Human beings persist in an extraordinary range of ecological settings, in the process exhibiting enormous behavioural diversity, both within and between populations. People vary in their social, mating and parental behaviour and have diverse and elaborate beliefs, traditions, norms and institutions. The aim of this theme issue is to ask whether, and how, evolutionary theory can help us to understand this diversity. In this introductory article, we provide a background to the debate surrounding how best to understand behavioural diversity using (...) evolutionary models of human behaviour. In particular, we examine how diversity has been viewed by the main subdisciplines within the human evolutionary behavioural sciences, focusing in particular on the human behavioural ecology, evolutionary psychology and cultural evolution approaches. In addition to differences in focus and methodology, these subdisciplines have traditionally varied in the emphasis placed on human universals, ecological factors and socially learned behaviour, and on how they have addressed the issue of genetic variation. We reaffirm that evolutionary theory provides an essential framework for understanding behavioural diversity within and between human populations, but argue that greater integration between the subfields is critical to developing a satisfactory understanding of diversity. (shrink)

Domain constraint, the requirement that analogues be selected from "the same category," inheres in the popular saying "you can't compare apples and oranges" and the textbook principle "the greater the number of shared properties, the stronger the argument from analogy." I identify roles of domains in biological, linguistic, and legal analogy, supporting the account of law with a computer word search of judicial decisions. I argue that the category treatments within these disciplines cannot be exported to general informal logic, where (...) the relevance of properties, not their number, must be the logically prior criterion for evaluating analogical arguments. (shrink)

Depue & Morrone-Strupinsky (D&M-S) do not address how a reward system accommodates the motivational dilemmas associated with (a) the decision to approach versus avoid conspecifics, and (b) self versus other tradeoffs inherent in behaving altruistically toward bonded relationship partners. We provide an alternative evolutionary view that addresses motivational conflict, and discuss implications for the neurobiological study of affiliative bonds.

Kinetochores can form and be maintained on DNA sequences that are normally non‐centromeric. The existence of these so‐called neo‐centromeres has posed the problem as to the nature of the epigenetic mechanisms that maintain the centromere. Here we highlight results that indicate that the amount of CENP‐A at human centromeres is tightly regulated. It is also known that kinetochore assembly requires sister chromatid cohesion at mitosis. We therefore suggest that separation or stretching between the sister chromatids at metaphase reciprocally determines the (...) amount of centromere assembly in the subsequent interphase. This reciprocal relationship forms the basis of a negative feedback loop that could precisely control the amount of CENP‐A and faithfully maintain the presence of a kinetochore over many cell divisions. We describe how the feedback loop would work, propose how it could be tested experimentally and suggest possible components of its mechanism. (shrink)

David Brown (b. 1948) is a Scottish Episcopal priest and theologian whose work covers a vast terrain spanning methodological divisions between philosophy, Christian theology, religious studies, the arts and culture. Early work on the Trinity and Incarnation led to a Newman-inspired articulation of Scripture as tradition, and, related to this, the exploration of tradition as revelation with reference to a wide range of human experience. Moving from materially-mediated divine presence to culturally-mediated revelation, Brown's phenomenology of religious experience amounts (...) to a transformed natural religion along sacramental lines. Essays in this volume consider Brown's wide ranging and generative contributions in three parts: 1) Butler & Newman, 2) Incarnation & Trinity, and 3) Sacramentality & the Arts, with a concluding response from Brown himself that addresses 'religious experience and revelation', as well as 'secular culture and religious distinctiveness'. (shrink)

For those who have been impressed or perplexed by the phenomenon of Marcuse, this collection of essays helps us to understand and reconstruct his own intellectual development. Most of the essays were written in the years from 1934 to 1938 when Marcuse had emigrated to the United States, and they were originally published in German in the Zeitschrift fur Sozialforschung. The influence of Hegel and Marx are strong, and the revulsion with the betrayal of German existentialism is evident. The essay (...) "Philosophy and Critical Theory," helps to clarify the type of theoretical activity which Marcuse thinks of himself as practicing. "The Concept of Essence" is perhaps the clearest statement one will find in Marcuse of what he means by "essence" and how it is supposed to serve as a standard for negations. In "On Hedonism," we discover what Marcuse means by happiness and its relevance for critical theory. These early essays are much more philosophical than Marcuse's later writings and do lay bare both the strengths and weaknesses of his critical theory. An unpublished essay "Aggressiveness in Advanced Industrial Society" is included as well as Marcuse's review of Norman O. Brown's Love's Body. The forward presents Marcuse view of these essays from a contemporary perspective.--R. J. B. (shrink)