In this study we use dual process theory of self-regulation to develop a framework that outlines the mediating and moderating mechanisms explaining the relationship between leader emotional exhaustion and leadership style (transformational leadership and abusive supervision). Using Glomb et al.’s (2011) framework, we identify empathy and negative emotion as mediators that are of particular importance for leaders. In addition, we propose that leader mindfulness moderates these processes to improve leadership style. Using a time-lagged survey of leaders (N = 505) we (...) found that leader empathy and negative emotion mediated the relationships between emotional exhaustion and leadership style. Furthermore, we found that leader mindfulness significantly moderated the indirect effect of leader emotional exhaustion on leadership style through negative emotion. However, leader mindfulness did not moderate the relationship between emotional exhaustion and empathy. Theoretical and practical implications are discussed. (shrink)

Serious ethical violations in medicine, such as sexual abuse, criminal prescribing of opioids, and unnecessary surgeries, directly harm patients and undermine trust in the profession of medicine. We review the literature on violations in medicine and present an analysis of 280 cases. Nearly all cases involved repeated instances of intentional wrongdoing, by males in nonacademic medical settings, with oversight problems and a selfish motive such as financial gain or sex. More than half of cases involved a wrongdoer with a suspected (...) personality disorder or substance use disorder. Despite clear patterns, no factors provide readily observable red flags, making prevention difficult. Early identification and intervention in cases requires significant policy shifts that prioritize the safety of patients over physician interests in privacy, fair processes, and proportionate disciplinary actions. We explore a series of 10 questions regarding policy, oversight, discipline, and education options. Satisfactory answers to these questions will require input from diverse stakeholders to help society negotiate effective and ethically balanced solutions. (shrink)

The spacing effect is among the most widely replicated empirical phenomena in the learning sciences, and its relevance to education and training is readily apparent. Yet successful applications of spacing effect research to education and training is rare. Computational modeling can provide the crucial link between a century of accumulated experimental data on the spacing effect and the emerging interest in using that research to enable adaptive instruction. In this paper, we review relevant literature and identify 10 criteria for rigorously (...) evaluating computational models of the spacing effect. Five relate to evaluating the theoretic adequacy of a model, and five relate to evaluating its application potential. We use these criteria to evaluate a novel computational model of the spacing effect called the Predictive Performance Equation. Predictive Performance Equation combines elements of earlier models of learning and memory including the General Performance Equation, Adaptive Control of Thought—Rational, and the New Theory of Disuse, giving rise to a novel computational account of the spacing effect that performs favorably across the complete sets of theoretic and applied criteria. We implemented two other previously published computational models of the spacing effect and compare them to PPE using the theoretic and applied criteria as guides. (shrink)

Arendt Contra Sociology re-assesses the relationship between Hannah Arendt's work and the theoretical foundations of sociology, bringing her insights to bear on key themes within contemporary theoretical sociology. Departing from the view of Arendt as a political theorist who sought to rescue politics from society, and political theory from the social sciences, this book re-examines her distinctions between labour, fabrication and action as a theory of the fundamental ontology of human societies, revisiting her criticism of the tendency of many sociological (...) paradigms to conflate the activity of fabrication with that of action. (shrink)

Technology and its interfaces with nursing care, patients and carers, and the home are many and varied. To date, healthcare services research has generally focussed on pragmatic issues such access to and the optimization of technology, while philosophical inquiry has tended to focus on the ethics of how technology makes the home more hospital like. However, the ethical implications of the ways in which technology shapes the subjectivities of patients and carers have not been explored. In order to explore this, (...) poststructural theory, in particular the work of Butler, Foucault, and Deleuze, is used to theorize the relationship between subjectivity and materiality as ethically mandated on producing rather than precluding the development of subjectivities in novel ways. This theoretical understanding is then utilized through a process of ‘plugged in’ as described by Jackson and Massie that aims to link empirical data, research, and philosophical inquiry. Through this process, it is suggested that power, which the empirical data demonstrate, is frequently exercised through medical discourses and restricts patients' and carers' ability to shape the material environment of the home as a place to live and be cared for in palliative stages of illness. Alternative discourses are suggested both from the empirical data as well as other research, which may offer patients and carers the possibility of reclaiming power over the home and their subjectivities. Finally, the dichotomy between the home and hospital, mediated via technology, is posited as being problematic. It is argued the dichotomy is false and should be moved away from in order to allow an ethical embrace of technology in palliative care. (shrink)

To function well in an unpredictable environment using unreliable components, a system must have a high degree of robustness. Robustness is fundamental to biological systems and is an objective in the design of engineered systems such as airplane engines and buildings. Cognitive systems, like biological and engineered systems, exist within variable environments. This raises the question, how do cognitive systems achieve similarly high degrees of robustness? The aim of this study was to identify a set of mechanisms that enhance robustness (...) in cognitive systems. We identify three mechanisms that enhance robustness in biological and engineered systems: system control, redundancy, and adaptability. After surveying the psychological literature for evidence of these mechanisms, we provide simulations illustrating how each contributes to robust cognition in a different psychological domain: psychomotor vigilance, semantic memory, and strategy selection. These simulations highlight features of a mathematical approach for quantifying robustness, and they provide concrete examples of mechanisms for robust cognition. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:“Normalizing” Intersex Didn’t Feel Normal or Honest to Me.Karen A. WalshI am an intersex woman with Complete Androgen Insensitivity Syndrome (CAIS). My 57–year history with this has its own trajectory—mostly driven by medical events, and how I and my parents reacted. Most of my treatment by physicians has not been positive. It didn’t make me “normal” at all. I was born normal and didn’t require medical interventions. And by (...) the way, I’ve never been confused about who or what I am.Truthful disclosure didn’t come to me about my biology and what was done to me as an infant until I was 33, when I forced the issue by removing my medical records from my endocrinologist’s office. I learned that there was never full disclosure to my [End Page 119] parents either, and therefore there was no informed consent for the “corrective” surgeries performed on me as an infant. My parents were only told that their little girl would get cancer and would not have a normal development as a girl unless her “deformed ovaries” were removed, and that they should never discuss these problems with me. Thus, after having presented with an inguinal hernia and having exploratory surgery at age 16 months, my intra–abdominal testes were removed in a second surgery two months later. I was pronounced a “male pseudohermaphrodite,” a diagnosis that was shared neither with my parents nor with me.Years later, I discovered an article my surgeon published in 1960 in the Delaware Medical Journal about me and another intersex person he operated on (whom he labeled a “true hermaphrodite”). The article gives a very detailed pathology report of my gonads, but only two sentences regarding my welfare and the rationale for performing those surgeries. Dr. J. F. Kustrup wrote in this article, “These [two cases] emphasize the need for early diagnosis and treatment in order to avoid the possibility of malignant change and to permit these individuals to follow a normal psychosexual pattern.” And: “Hermaphroditism and pseudohermaphroditism are conditions in which early diagnosis and treatment are essential to avoid malignant degeneration and to allow the child some chance toward normal pyschic [sic] development.” I was grateful to find this article because it revealed the unfounded assumptions underpinning the recommendations for treatment, much of which continues today. Worse even than the sort of social prejudice that shapes treatment is the absence of evidence for what doctors treat as “necessary” interventions. For my syndrome, CAIS, there never was—and still is not—data to support the cancer scare, or the opinion that I’d be confused and not have a normal life.From about the age of four, I can remember being different and being stonewalled by my doctor and prevented by my parents from talking about it. The feelings and fears I tried to express were shushed away, and I could tell that my questions were upsetting everyone. Even if I had wanted to be complicit with their lame diversions and nonsensical explanations, the massive abdominal scars were there as a daily reminder and hinted at a very different story.The Road to Hell is Paved with Good IntentionsGrowing up, I was treated like a fascinoma and a lab rat at a major teaching hospital on the East Coast. All I learned from those doctors as a young kid was what it feels like to be ogled, photographed and probed by a roomful of white–coated male doctors. Dissociation made itself my friend, and helped me to cope through the annual genital and anal exams and probing. I thought I was a freak and I felt completely powerless to protect myself from them and their “care”.At my annual appointment at age 12, with my mom present, three doctors told me I was infertile. Learning that I couldn’t have kids really saddened and shocked me, but there was no opportunity to talk about my feelings—either that day, or any time afterward. I was told to stop crying. I remember them telling me that there was no one else like me and that this was a random genetic anomaly, thereby reinforcing the freakishness... (shrink)

This symposium includes twelve personal narratives from parents about making the decision whether to circumcise their infant male children. The authors of the narratives include five fathers and seven mothers. Nine of the 12 parent authors opted to circumcise their infant sons, though the reasons they stated for doing so varied. Most of the parent authors relied on cultural or social beliefs, religious guidance, or a desire for sameness with the infant's father. Parents who didn't circumcise their male infants discuss (...) their convictions about autonomy, bodily rights, and the medical benefits of circumcision versus the harm or pain caused by the procedure. The symposium includes four expert commentaries on the narratives that are informed and enriched by the commentators' expertise in pediatric bioethics, healthcare ethics, gender studies, Jewish law and tradition, and the medical and surgical techniques of circumcision. (shrink)

Stimulated by our conversations at the 2018 International Philosophy of Nursing Society Conference and our shared interests, the coauthors present an argument for augmenting the broader discussion of “missed care” with our synthesized concept called structural missingness. We take the problem of missed care to be largely grounded on a particular economic construction of the healthcare system within an era of what some are calling the Capitalocene, capturing the pervasive influence of capitalism on nature, humanity and the world order. Our (...) perspective is that of the United States, however, extrapolations can be made to the social and healthcare systems in other countries. We are concerned with the underlying conditions that structurally reify inequality and ultimately undermine nursing practice. To situate the discussion, we briefly review existing literature on the contextualization of missed care. We understand contemporary circumstances of missed care as a function of the neoliberalization of healthcare, including the idea of nursing as a commodity. From this, we discuss the implications of missed care, which forms the basis of our critique. Synthesizing the term “structural missingness, we locate a moral imperative in the professional and disciplinary commitments of nursing to consider who and what have been left out. This moral imperative for the nursing profession, along with other social and health related professions, underscores our obligation to be involved in uncovering inequities and conceptualizing upstream solutions for structural missingness. (shrink)

State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public. However, there is noteworthy variability in the extent to which SMBs impose severe disciplinary action. In this manuscript, we present and synthesize a subset of 11 recommendations based on findings from our team’s larger consensus-building project that identified a list of 56 policies and legal provisions SMBs can use to better protect patients from egregious (...) wrongdoing by physicians. (shrink)

Pedagogical situations require white lies: in teaching philosophy we make decisions about what to omit, what to emphasise, and what to distort. This article considers when it is permissible to distort the historical record, arguing for a tempered respect for the historical facts. It focuses on the rationalist/empiricist distinction, which still frames most undergraduate early modern courses despite failing to capture the intellectual history of that period. It draws an analogy with Michael Strevens's view on idealisation in causal explanation to (...) distinguish between myths and caricatures. Myths are distortions of the historical record that undermine students' understanding of the past, despite having other pedagogical benefits. Caricatures are distortions that either increase or are indifferent to understanding of the past. Mythmaking, the article argues, is unjustified. (shrink)

How do people understand questions about cause and prevent? Some theories propose that people affirm that A causes B if A's occurrence makes a difference to B's occurrence in one way or another. Other theories propose that A causes B if some quantity or symbol gets passed in some way from A to B. The aim of our studies is to compare these theories' ability to explain judgements of causation and prevention. We describe six experiments that compare judgements for causal (...) paths that involve a mechanism, i.e. a continuous process of transmission or exchange from cause to effect, against paths that involve no mechanism yet a change in the cause nevertheless brings about a change in the effect. Our results show that people prefer to attribute cause when a mechanism links cause to effect. In contrast, prevention is sensitive both to the presence of an interruption to a causal mechanism and to a change in the outcome in the absence of a mechanism. In this sense, ‘prevent’ means something different than ‘cause not'. We discuss the implications of our results for existing theories of causation. (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)

Quality of care is a prominent discourse in modern health‐care and has previously been conceptualised in terms of ethics. In addition, the role of knowledge has been suggested as being particularly influential with regard to the nurse–patient–carer relationship. However, to date, no analyses have examined how knowledge (as an ethical concept) impinges on quality of care. Qualitative semi‐structured interviews were conducted with 26 patients with palliative and supportive care needs receiving district nursing care and thirteen of their lay carers. Poststructural (...) discourse analysis techniques were utilised to take an ethical perspective on the current way in which quality of care is assessed and produced in health‐care. It is argued that if quality of care is to be achieved, patients and carers need to be able to redistribute and redevelop the knowledge of their services in a collaborative way that goes beyond the current ways of working. Theoretical works and extant research are then used to produce tentative suggestions about how this may be achieved. (shrink)

Husserlian phenomenology, as the study of conscious experience, has often been accused of solipsism. Husserl’s method, it is argued, does not have the resources to provide an account of consciousness of other minds. This chapter will address this issue by providing a brief overview of the multiple angles from which Husserl approached the theme of intersubjectivity, with specific focus on the details of his account of the concrete interpersonal encounter – “empathy.” Husserl understood empathy as a direct, quasi-perceptual form of (...) intentionality through which the sense of the Other is constituted. Furthermore, his account of empathy is holistically integrated with his overall theory of intersubjectivity, including his discussions of the objectivity of nature, and the social, historical, and communal aspects of subjectivity. Husserl’s theory of empathy continues to cast a long shadow, influencing both the analytic and continental approaches to the problem of other minds, as well as contemporary account of social cognition in the cognitive sciences. (shrink)

Singles are an understudied yet growing segment of the adult population. The current study aims to expand the lens of relationship science by examining the well-being of unpartnered, single adults using latent profile analysis. We recruited singles closely matched to the United States census for an exploratory cross-sectional survey using five variables that strongly predict well-being. All five variables significantly predicted life satisfaction for the full sample. Latent profile analyses detected 10 groups of singles. Half of the profiles were happy (...) and half of the profiles were unhappy. Each profile had its own unique patterns relating to personal relationships, self-esteem, and personality traits. The happiest profile had the best relationships, self-esteem, and personality, while the unhappiest profile had the worst relationships, self-esteem, and personality. The profiles in between these two extremes had more nuanced patterns. For example, one relatively happy profile in the middle had high friendship satisfaction but low family satisfaction, while an adjacent profile showed the opposite pattern. Overall, singles who had positive relationships—both with themselves and others—were happiest. (shrink)

This paper argues for a Husserlian account of phenomenal intentionality. Experience is intentional insofar as it presents a mind-independent, objective world. Its doing so is a matter of the way it hangs together, its having a certain structure. But in order for the intentionality in question to be properly understood as phenomenal intentionality, this structure must inhere in experience as a phenomenal feature. Husserl’s concept of horizon designates this intentionality-bestowing experiential structure, while his concept of motivation designates the unique phenomenal (...) character of this structure as it is experientially lived through. The way experience hangs together is itself a phenomenal feature of experience. (shrink)

For children, the collateral damage of the COVID-19 pandemic response has been considerable. In this paper, we use the framework of evidence-based medicine to argue that child abuse is another negative side effect of COVID-19 lockdowns. While it was certain that school closures would have profound social and economic costs, it remains uncertain whether they have any effect on COVID-19 transmission. There is emerging evidence that lockdowns significantly worsened child abuse on a global scale. Low-income and middle-income countries are particularly (...) vulnerable to increases in child abuse. The best available external evidence from systematic research during the pandemic demonstrates an increase in the risk of child maltreatment, an increase in child maltreatment hospitalisations and a concerning decrease in official child maltreatment referrals. The paradoxical phenomenon of increased hospitalisations and decreased reports is unlikely to be explained by a genuine decrease in child abuse. We conclude that lockdowns have an unacceptably high risk of negative side effects for children, as evidenced by child abuse, the true extent of which appears to be masked by lockdown-related disruptions to schools and other surveillance systems. The desire for a sense of security may be a tempting bias towards emphasising the resilience of children, but it is ethically problematic to push children towards abuse in the name of public health. It is our view that the collateral damage of prolonged school closures for society’s most vulnerable members is a powerful ethical consideration against any pandemic response which involves their use. (shrink)