SummaryIn 1968, a prospective study was started in collaboration with the Family Planning Association to try to provide a balanced view of the beneficial and harmful effects of different methods of contraception. This investigation is now in progress at seventeen clinics and over 17,000 women are under observation. At the time of recruitment, all these women were married white British subjects, aged 25–39 years, who voluntarily agreed to participate. Fifty-six per cent were using oral contraceptives, 25% were using a diaphragm (...) and 19% were using an intrauterine device. During follow-up each woman is questioned at return visits to the clinic and a record of pregnancies and their outcome, hospital referrals, changes in contraceptive methods and the results of cervical smears, is accumulated. Women who default are sent a postal questionnaire and, if this is not returned, are telephoned or visited in their homes to collect the necessary information.So far, data obtained during 56,000 woman-years of observation are available for analysis. Follow-up has been maintained with an annual lapse rate of about 0.3%due to withdrawal of co-operation or loss of contact; adherence to the method of contraception in use at recruitment has been reasonably good, and the reporting of pregnancies and hospital admissions appears to have been both reliable and unbiased.The present data include only 24 deaths, so the mortality associated with different contraceptive methods cannot yet be estimated. With regard to morbidity, however, our preliminary results closely resemble those obtained in the prospective study carried out by the Royal College of General Practitioners and in the principal retrospective studies carried out in Britain and the United States. Women who used oral contraceptives at the start of the study experienced adeficiencyof hospital referrals for cancer, benign lesions of the breast, menstrual disorders other than amenorrhoea, duodenal ulcer, and retention cysts of the ovary; they showed anexcessof referrals for cerebrovascular disease, cervical erosion, skin disorders, self-poisoning, migraine, venous thrombosis and embolism, hayfever, gallbladder disease, amenorrhoea, and sterility. Women who used a diaphragm showed adeficiencyof hospital referrals for carcinoma-in-situ and dysplastic lesions of the cervix uteri and accidental injury; and anexcessof referrals for haemorrhoids and cystitis. Women who used an IUD experienced anexcessof hospital referrals for anaemia, varicose veins and salpingitis. About half of these differences were predicted from other studies while some suggestive evidence already existed for a further five. Of the remaining six, some probably reflect the influence of selective factors or chance.Multiple pregnancies, stillbirths, malformations, the sex ratio and birthweight showed no consistent relationship to method of contraception. The outcome of unplanned pregnancies occurring in women using an IUD, however, was remarkably unfavourable both in terms of ectopic gestation and miscarriage.Clear evidence was found of impairment of fertility after discontinuation of oral contraceptives. Whether this is likely to lead to permanent sterility in some women is uncertain.The study has provided data on the efficacy of a wide variety of contraceptive methods. In general the failure rates are in keeping with those obtained in other large-scale studies, save that those for the diaphragm and the sheath are much lower than those usually quoted.The available evidence does not yet allow a final balance to be struck between the benefits and risks associated with the new methods of contraception that have become widely used during the last two decades. It seems clear, however, that there are no material risks associated with the use of the diaphragm apart from the risk of pregnancy and that there may be some unintended benefits. (shrink)

Dissociative experiences have been associated with diachronic disunity. Yet, this work is in its infancy. Dissociative identity disorder is characterized by different identity states reporting their own relatively continuous sense of self. The degree to which patients in dissociative identity states experience diachronic unity has not been empirically explored. This study examined the degree to which patients in dissociative identity states experienced diachronic unity. Participants were DID adults assessed in adult and child identity states, adults with a psychotic illness, adults (...) from the general population, children from the general population and adults imagining themselves as children. They completed the Diachronic Disunity Scale, the Dissociative Experiences Scale, and the Self-Concept Clarity Scale. Diachronic disunity was not limited to psychiatric groups, but evident to some degree in all adult and child samples. The DID adult sample experienced more dissociation and self-confusion than the psychosis and adult comparison groups, but did not differ on the diachronic measure. DID patients in their child identity states and child comparisons showed disunity and were significantly different from child simulators, who showed relatively more unity. Results suggest that DID patients in either adult or child dissociative identity states, like those in other samples, do not universally experience themselves as having a consistent sense of self over time. (shrink)

ABSTRACT:Despite widespread attention to corruption and organizational change in the literature, to our knowledge, no research has attempted to understand the linkages between these two powerful organizational phenomena. Accordingly, we draw on major theories in ethics, sociology, and management to develop a theoretical framework for understanding how organizational change can sometimes generate corruption. We extend anomie theory and ethical climate theory to articulate the deinstitutionalization of the normative control system and argue that, through this deinstitutionalization, organizations have the potential to (...) become incubators for corruption. We qualify this process by proposing conditions more ripe for anomie and under which this deinstitutionalization is more likely to occur, propounding moderating relationships that influence organizational reconfiguration. Examples of turbulence in the contemporary business environment that can trigger change highlight our discussion. We conclude with managerial implications, offering means by which the deleterious effects of corruption may be arrested or controlled. (shrink)

The extant marketing literature provides little guidance for theory development or practice with regard to questions of ethical conformity and the resulting market response. To begin to bridge this research gap, we advance a theoretical framework of ethical conformity in marketing, appealing to marketing ethics, management strategy, and sociological foundations. We set the stage for our theoretical arguments by considering the role of normative expectations related to marketing practices and behaviors held by societal constituents. Against this backdrop, we propose drivers (...) of conformity in marketing, including practices consistent with both overconformity and underconformity. The framework allows us to advance testable research propositions by which questions of ethical conformity may be explored. We conclude by suggesting additional future research needed to develop the domain, specifically in the form of empirical inquiries uncovering firm strategic decisions with ethical implications. (shrink)

ABSTRACT:Anomie is a condition in which normative guidelines for governing conduct are absent. Using survey data from a sample of U.S. manufacturing firms, we explore the impact of internal (cultural) and external (environmental) determinants of organizational anomie. We suggest that four internal organizational factors can generate or suppress organizational anomie, including strategic aggressiveness, long-term orientation, competitor orientation, and strategic flexibility. Similarly, we argue that external contextual factors, including competitive intensity and technological turbulence, can influence organizational anomie. We extend anomie and (...) ethics research by considering the impact of these firm cultural and environmental factors according to whether firms are publicly-traded or privately-held. Findings demonstrate that a number of firm cultural and environmental factors can generate or reduce anomie in firms. Moreover, strategic aggressiveness, long-term orientation, and strategic flexibility influence organizational anomie differently depending on whether the firm is publicly-traded or privately-held. Theoretical and practical implications of our findings are discussed. (shrink)

The Chief Medical Officer of Health of the United Kingdom has recommended that the 1990 Human Fertilisation and Embryology Act should be amended to allow cloning in humans for research purposes only. He also recommended that: “The transfer of an embryo created by cell nuclear replacement into the uterus of a woman (so called ‘reproductive cloning’) should remain a criminal offence” (recommendation 7, Ref. 1). This recommendation implies that nuclear replacement and cloning are the same. They are not. Nuclear transfer (...) constitutes reproductive cloning only when the individual created is genetically identical to the nuclear donor. In this paper, we describe a possible future use of nuclear transfer for the treatment of infertile individuals. The treatment yields an individual that receives approximately equal genetic contributions from each parent. We use this example to illustrate how semantic confusion might lead to plausibly moral and justifiable treatments being legally banned. In doing so, we hope to encourage a more accurate and informed use of language in science, law and politics, so that legislation is properly informed by science and achieves what it intends. BioEssays 23:359–364, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

We are each the product of our development. The nature of the developmental process by which each of us was formed is described from gametogenesis to neonatality. The varied influences upon that process and their relative balance and patterns of interaction are then considered. In particular, the relative importance of epigenetic and genetic factors is discussed. It is concluded that development is a continuous process involving epigenetic/genetic interactions throughout. The contemporary emphasis on the genetic basis for human individuality is reviewed (...) critically. (shrink)

Focused on the field of knowledge lying between digital and analog circuit theory, this new text will help engineers working with digital systems shorten their product development cycles and help fix their latest design problems. The scope of the material covered includes signal reflection, crosstalk, and noise problems which occur in high speed digital machines (above 10 megahertz). This volume will be of practical use to digital logic designers, staff and senior communications scientists, and all those interested in digital design.

Employee reporting dishonesty is a significant area of concern for firms. In this study, we investigate how providing information about their prosocial actions, such as organizational citizenship behaviors, affects the extent of employee reporting dishonesty. We distinguish prosocial actions whose welfare effects are mutually beneficial (i.e., that help others and the employee), which are common in business practice, from those that are selfless in nature (i.e., that help others at a personal cost to the employee). In addition to examining the (...) effect of the type of prosocial action on the extent of employee reporting dishonesty, we also examine the effect of construal (the manner in which individuals perceive and interpret the action). Using an experiment, we find that participants with high moral identity are less dishonest when they describe their selfless prosocial actions than when they describe their mutually beneficial prosocial actions, but only when they abstractly construe this information. However, we do not find evidence that the reporting dishonesty of participants with low moral identity is influenced by the type of prosocial action they provide information about or the construal of that information. We discuss implications of these results for theory and practice. (shrink)

This work makes a substantial reexamination of the social processes behind the labelling of patients in hospital care. Taking an interpretive perspective, the author analyses the social construction of patient labels, identifying strategies for and the consequences of giving and receipt of 'good' and 'bad' labels.

A major obstacel to the study of mammalian development, and to the practical application of knowledge gained from it in the clinic during therapeutic in vitro fertilisation and embryo transfer (IVF‐ET), is the propensity of embryos to become retarded or arrested during their culture in vitro. The precise developmental cell cycle in which embryos arrest or delay is characteristic for the species and coincides with the earliest period of embryonic gene expression. Much evidence reviewed here implicates free oxygen radicals (FORs) (...) in the process of arrest. Thus, studies on the development of mouse preimplantation embryos in vitro have shown that (i) FORs are elevated in vitro, but not in vivo, at the time at which embryos become arrested or delayed, (ii) systems for removing reactive oxygen species to limit the formation of hydroxy radicals are present, although they have not yet been assessed quantitatively and may differ qualitatively from those in adult cells, (iii) metabolic and possibly genetic adaptations to oxidative damage are evident, (iv) published procedures for overcoming in vitro arrest are explicable in terms of FOR‐mediated damage or responses and (v) the arrest or delay of most embryos in vitro can be reduced or prevented experimentally by addition of metal chelators to limit hydroxy radical formation and lipid hydroperoxidation. (shrink)

Police killings of unarmed Black people have ignited a national and international response unlike any in decades. But differing from their civil rights-oriented predecessors, today’s activists do not think that the institutions and values of liberal democracy can eradicate structural racism. They draw instead on a Black radical tradition that, Terrence L. Johnson argues, derives its force from its unacknowledged ethical and religious dimensions. We Testify with Our Lives traces Black religion’s sustained influence from SNCC to the present, reconstructing (...) a radical lived ethics of freedom and justice. Johnson demonstrates that Black Power fundamentally contests liberalism’s abstract understanding of democracy, calling instead for new embodied frameworks to achieve human flourishing and dignity. Black bodies represent the primary form of resistance against violent and oppressive regimes of white supremacy and exploitation, and the individual and collective struggles of Black life bear witness to the dogged determination to cultivate beauty, rage, and joy. Considering the writings of Audre Lorde, Toni Cade Bambara, Stokely Carmichael, Martin Luther King Jr., Malcolm X, and James Baldwin, We Testify with Our Lives makes its case through a new narrative of the evolution of Black radicalism from the civil rights movement through the Movement for Black Lives. It forges new insights into Black Power’s vital contributions to debates on ethics, transnational politics, democracy, political solidarity, and freedom—and its potent resources for the ongoing struggle to build democratic possibilities for all. (shrink)

The focus on translational research in clinical trials has the potential to generate clinically relevant genetic data that could have importance to patients. This raises challenging questions about communicating relevant genetic research results to individual patients. An exploratory pharmacogenetic analysis was conducted in the international ovarian cancer phase III trial, AGO-OVAR 16, which found that patients with clinically important germ-line BRCA1/2 mutations had improved progression-free survival prognosis. Mechanisms to communicate BRCA results were evaluated, because these findings may be beneficial to (...) patients and their families. Communicating individual BRCA results was not anticipated during clinical trial design. Consequently, options were not available for patients to indicate their preference for receiving their individual results when they signed pharmacogenetic informed consent. Differences in local requirements, clinical practice, and opinion regarding the ethical aspects of how to convey genetic results to patients are all potential barriers to returning individual BRCA results to patients. Communicating the aggregate BRCA result from this study provided clinical investigators with a mechanism to disseminate the overall study finding to patients while taking individual circumstances, local guidelines and clinical practice into account. This study illustrates the importance of increasing the clarity and scope of informed consent and the need for patient engagement to ensure clinical trial participants can indicate their preference regarding receipt of potentially important individual pharmacogenetic results. This study was registered in the NCT Clinical Trial Registry under NCT00866697 on March 19, 2009, following approval from participating ethics committees. (shrink)

The invisibility of nursing work has been discussed in the international literature but not in relation to learning clinical skills. Evans and Guile's (Practice‐based education: Perspectives and strategies, Rotterdam: Sense, 2012) theory of recontextualisation is used to explore the ways in which invisible or unplanned and unrecognised learning takes place as newly qualified nurses learn to delegate to and supervise the work of the healthcare assistant. In the British context, delegation and supervision are thought of as skills which are learnt (...) “on the job.” We suggest that learning “on‐the‐job” is the invisible construction of knowledge in clinical practice and that delegation is a particularly telling area of nursing practice which illustrates invisible learning. Using an ethnographic case study approach in three hospital sites in England from 2011 to 2014, we undertook participant observation, interviews with newly qualified nurses, ward managers and healthcare assistants. We discuss the invisible ways newly qualified nurses learn in the practice environment and present the invisible steps to learning which encompass the embodied, affective and social, as much as the cognitive components to learning. We argue that there is a need for greater understanding of the “invisible learning” which occurs as newly qualified nurses learn to delegate and supervise. (shrink)

This book highlights some of the most pressing safety, ethical, legal and societal issues related to the diverse contexts in which robotic technologies apply. Focusing on the essential concept of well-being, it addresses topics that are fundamental not only for research, but also for industry and end-users, discussing the challenges in a wide variety of applications, including domestic robots, autonomous manufacturing, personal care robots and drones.

This project examined the ethical issues faced by academics and professionals in the Humanities. We conducted focus groups to gather information about the ethical concerns in these fields and used the qualitative data arising from the discussions to create a taxonomy that represents the structure of ethical issues in the Humanities. A key implication of our findings is that while the focus of ethics research and interventions has been primarily on the sciences and engineering, academics and professionals in other fields (...) also encounter some unique critical ethical dilemmas that require further research and methods of intervention. (shrink)

Recently the relevance of the philosophy of Martin Heidegger has been critiqued in nursing literature. However, this critique is based primarily upon an appropriation of Heidegger that does not reflect an understanding of meaning as grounded in temporality. Therefore, this paper aims to (1) explicate Heidegger's grounding of meaning, (2) briefly contrast Heidegger's and Husserl's notions of the origin of meaning, (3) describe how Heidegger was first introduced to nursing, and (4) illustrate through examples from a research study how (...) the philosophy of Heidegger might inform the phenomenological researcher. (shrink)

Counting functions are shown to be complete by using a simpler argument than that used by Pelletier and Martin.

In Atheism: A Philosophical Justification, Michael Martin argues that to posit a God that is both omnipotent and omniscient is philosophically incoherent. I challenge this argument by proposing that a God who is necessarily omniscient is more powerful than a God who is contingently omniscient. I then argue that being omnipotent entails being omniscient by showing that for an all-powerful being to be all-powerful in any meaningful way, it must possess complete knowledge about all states of affairs and thus (...) must be understood to be omniscient. (shrink)

El presente trabajo se propone discutir acerca de los límites entre el Análisis del Dasein de Medard Boss y la Analítica del Dasein de Martin Heidegger. Tomando como punto de partida la aparición de la dimensión orgánica en las consideraciones de Boss, se discutirá cómo es que se devela una oposición en los énfasis temáticos correspondientes a una consideración filosófica y a una psicológica del ser humano. Dicha oposición será aclarada indagando en las respectivas motivaciones de ambos programas, para (...) destacarlas como sus eminentes límites. Finalmente, comprendiendo dichas motivaciones como límites, el artículo planteará que la insistencia de lo orgánico vigente aún en Boss señalaría problemáticas que pueden competer aun a la Analítica del Dasein del mismo Heidegger. (shrink)